Provider Demographics
NPI:1093213464
Name:WILLIAMS COUNTY SOCIAL SERVICES
Entity Type:Organization
Organization Name:WILLIAMS COUNTY SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE STAFF OFFICER I
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-774-6300
Mailing Address - Street 1:110 W BROADWAY STE 202
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-6056
Mailing Address - Country:US
Mailing Address - Phone:701-774-6300
Mailing Address - Fax:701-572-9794
Practice Address - Street 1:110 W BROADWAY STE 202
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-6056
Practice Address - Country:US
Practice Address - Phone:701-774-6300
Practice Address - Fax:701-572-9794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1466349Medicaid