Provider Demographics
NPI:1689306540
Name:YWCA CASS CLAY
Entity Type:Organization
Organization Name:YWCA CASS CLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-232-2547
Mailing Address - Street 1:4650 38TH AVE S STE 110
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8529
Mailing Address - Country:US
Mailing Address - Phone:701-232-2547
Mailing Address - Fax:
Practice Address - Street 1:4650 38TH AVE S STE 110
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8529
Practice Address - Country:US
Practice Address - Phone:701-232-2547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management