Provider Demographics
NPI:1215906680
Name:CITY OF SLEEPY EYE
Entity type:Organization
Organization Name:CITY OF SLEEPY EYE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SELLHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-794-8440
Mailing Address - Street 1:400 4TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SLEEPY EYE
Mailing Address - State:MN
Mailing Address - Zip Code:56085-1109
Mailing Address - Country:US
Mailing Address - Phone:507-795-3691
Mailing Address - Fax:507-794-5950
Practice Address - Street 1:400 4TH AVENUE NW
Practice Address - Street 2:
Practice Address - City:SLEEPY EYE
Practice Address - State:MN
Practice Address - Zip Code:56085-0323
Practice Address - Country:US
Practice Address - Phone:507-794-3691
Practice Address - Fax:507-794-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261Q00000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
0186394OtherMEDICA
MN487308400Medicaid
CJ9359OtherMEDICARE RAILROAD
01013532OtherPREFERRED ONE
MN400031OtherUCARE RHC PHYSICIAN FEES
106628OtherUCARE SLEEPY EYE CLINIC
112501OtherUCARE MORGAN CLINIC
MN308014900Medicaid
MN7S90SLOtherBCBS-RHC
MN43202SLOtherBCBS PROF FEES & MORGAN
CJ9359OtherMEDICARE RAILROAD
MN487308400Medicaid
MN308014900Medicaid