Provider Demographics
NPI:1083175442
Name:SWWC SERVICE COOPERATIVES
Entity Type:Organization
Organization Name:SWWC SERVICE COOPERATIVES
Other - Org Name:THE READY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:TEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-537-2284
Mailing Address - Street 1:2419 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265
Mailing Address - Country:US
Mailing Address - Phone:507-537-2240
Mailing Address - Fax:
Practice Address - Street 1:2419 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265
Practice Address - Country:US
Practice Address - Phone:507-537-2240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SWWC SERVICE COOPERATIVES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-28
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency