Provider Demographics
NPI:1083845127
Name:COUNTY OF NICOLLET
Entity Type:Organization
Organization Name:COUNTY OF NICOLLET
Other - Org Name:NICOLLET COUNTY SOCIAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:HEALTH AND HUMAN SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SASSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-934-8573
Mailing Address - Street 1:622 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082-2106
Mailing Address - Country:US
Mailing Address - Phone:507-934-8573
Mailing Address - Fax:507-934-8552
Practice Address - Street 1:622 SO FRONT ST
Practice Address - Street 2:
Practice Address - City:SAINT PETER
Practice Address - State:MN
Practice Address - Zip Code:56082-2557
Practice Address - Country:US
Practice Address - Phone:507-934-8576
Practice Address - Fax:507-931-9562
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF NICOLLET
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-06
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNM706718600Medicaid