Provider Demographics
NPI:1154644375
Name:LE SUEUR COUNTY DHS
Entity Type:Organization
Organization Name:LE SUEUR COUNTY DHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOC SERV ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWIEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-357-8289
Mailing Address - Street 1:88 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LE CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:56057-1600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 S PARK AVE
Practice Address - Street 2:
Practice Address - City:LE CENTER
Practice Address - State:MN
Practice Address - Zip Code:56057-1600
Practice Address - Country:US
Practice Address - Phone:507-357-8288
Practice Address - Fax:507-357-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA000040000Medicaid