Provider Demographics
NPI:1235559683
Name:GRIGGS COUNTY
Entity Type:Organization
Organization Name:GRIGGS COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LSW/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRONNEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:701-797-2127
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:912 BURREL AVE SE
Mailing Address - City:COOPERSTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58425-0567
Mailing Address - Country:US
Mailing Address - Phone:701-797-2127
Mailing Address - Fax:701-797-2172
Practice Address - Street 1:912 BURREL AVE SE
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:ND
Practice Address - Zip Code:58425-0567
Practice Address - Country:US
Practice Address - Phone:701-797-2127
Practice Address - Fax:701-797-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3023251B00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare