Provider Demographics
NPI:1205065661
Name:RENVILLE COUNTY HUMAN SERVICES
Entity type:Organization
Organization Name:RENVILLE COUNTY HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUSTUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-523-2202
Mailing Address - Street 1:105 S 5TH ST STE 203H
Mailing Address - Street 2:
Mailing Address - City:OLIVIA
Mailing Address - State:MN
Mailing Address - Zip Code:56277-1374
Mailing Address - Country:US
Mailing Address - Phone:320-523-2202
Mailing Address - Fax:
Practice Address - Street 1:105 S 5TH ST STE 203H
Practice Address - Street 2:
Practice Address - City:OLIVIA
Practice Address - State:MN
Practice Address - Zip Code:56277-1374
Practice Address - Country:US
Practice Address - Phone:320-523-2202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENVILLE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare