Provider Demographics
NPI:1124222815
Name:TRAVERSE COUNTY SOCIAL SERVICES
Entity Type:Organization
Organization Name:TRAVERSE COUNTY SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-563-8255
Mailing Address - Street 1:202 8TH STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MN
Mailing Address - Zip Code:56296
Mailing Address - Country:US
Mailing Address - Phone:320-563-8255
Mailing Address - Fax:320-563-4230
Practice Address - Street 1:202 8TH STREET NORTH
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MN
Practice Address - Zip Code:56296
Practice Address - Country:US
Practice Address - Phone:320-563-8255
Practice Address - Fax:320-563-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare