Provider Demographics
NPI:1306851746
Name:TRI-COUNTY COMMUNITY CORRECTIONS
Entity Type:Organization
Organization Name:TRI-COUNTY COMMUNITY CORRECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-281-6363
Mailing Address - Street 1:600 BRUCE ST
Mailing Address - Street 2:
Mailing Address - City:CROOKSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56716-2918
Mailing Address - Country:US
Mailing Address - Phone:218-281-6363
Mailing Address - Fax:218-281-0403
Practice Address - Street 1:600 BRUCE ST
Practice Address - Street 2:
Practice Address - City:CROOKSTON
Practice Address - State:MN
Practice Address - Zip Code:56716-2918
Practice Address - Country:US
Practice Address - Phone:218-281-6363
Practice Address - Fax:218-281-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children