Provider Demographics
NPI:1942539846
Name:COUNTY OF WATONWAN
Entity Type:Organization
Organization Name:COUNTY OF WATONWAN
Other - Org Name:WATONWAN COUNTY HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHSENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-375-3294
Mailing Address - Street 1:715 2ND AVE S
Mailing Address - Street 2:PO BOX 31
Mailing Address - City:SAINT JAMES
Mailing Address - State:MN
Mailing Address - Zip Code:56081-1740
Mailing Address - Country:US
Mailing Address - Phone:507-375-3294
Mailing Address - Fax:507-375-7359
Practice Address - Street 1:715 2ND AVE S
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MN
Practice Address - Zip Code:56081-1740
Practice Address - Country:US
Practice Address - Phone:507-375-3294
Practice Address - Fax:507-375-7359
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF WATONWAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-24
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA000083300Medicaid