Provider Demographics
NPI:1679705727
Name:SOUTHWEST HEALTH AND HUMAN SERVICES
Entity Type:Organization
Organization Name:SOUTHWEST HEALTH AND HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-537-1248
Mailing Address - Street 1:607 W MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-3021
Mailing Address - Country:US
Mailing Address - Phone:507-537-6747
Mailing Address - Fax:507-537-6088
Practice Address - Street 1:607 W MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-3021
Practice Address - Country:US
Practice Address - Phone:507-537-6747
Practice Address - Fax:507-537-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6768063251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA000041800Medicaid
MNM000051500Medicaid
MNA000042600Medicaid