Provider Demographics
NPI:1346578051
Name:SWIFT COUNTY HUMAN SERVICES AGENCY
Entity Type:Organization
Organization Name:SWIFT COUNTY HUMAN SERVICES AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-843-3160
Mailing Address - Street 1:410 21ST STREET S
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:MN
Mailing Address - Zip Code:56215-0208
Mailing Address - Country:US
Mailing Address - Phone:320-843-3160
Mailing Address - Fax:
Practice Address - Street 1:410 21ST STREET S
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:MN
Practice Address - Zip Code:56215-0208
Practice Address - Country:US
Practice Address - Phone:320-843-3160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health