Provider Demographics
NPI:1851544811
Name:POPE COUNTY HUMAN SERVICES
Entity Type:Organization
Organization Name:POPE COUNTY HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-634-5750
Mailing Address - Street 1:211 MINNESOTA AVE E STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:56334-1668
Mailing Address - Country:US
Mailing Address - Phone:320-634-5750
Mailing Address - Fax:320-634-0164
Practice Address - Street 1:211 MINNESOTA AVE E STE 200
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MN
Practice Address - Zip Code:56334-1668
Practice Address - Country:US
Practice Address - Phone:320-634-5750
Practice Address - Fax:320-634-0164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1B159R8DSOtherBCBS