Provider Demographics
NPI:1003959883
Name:CHISAGO COUNTY HUMAN SERVICES
Entity Type:Organization
Organization Name:CHISAGO COUNTY HUMAN SERVICES
Other - Org Name:DROP IN CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF HEALTH & HUMAN SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MPH
Authorized Official - Phone:651-213-5684
Mailing Address - Street 1:313 N MAIN ST
Mailing Address - Street 2:RM 239
Mailing Address - City:CENTER CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55012-7698
Mailing Address - Country:US
Mailing Address - Phone:651-213-5600
Mailing Address - Fax:651-213-5685
Practice Address - Street 1:11549 LAKE LN
Practice Address - Street 2:STE 3
Practice Address - City:CHISAGO CITY
Practice Address - State:MN
Practice Address - Zip Code:55013-9592
Practice Address - Country:US
Practice Address - Phone:651-213-5751
Practice Address - Fax:651-213-5753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC04062Medicare ID - Type Unspecified