Provider Demographics
NPI:1720356439
Name:OLMSTED COUNTY
Entity Type:Organization
Organization Name:OLMSTED COUNTY
Other - Org Name:OLMSTED COUNTY CHILD & FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BAKKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-328-6460
Mailing Address - Street 1:2117 CAMPUS DR. SE
Mailing Address - Street 2:STE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904
Mailing Address - Country:US
Mailing Address - Phone:507-328-6400
Mailing Address - Fax:
Practice Address - Street 1:2117 CAMPUS DR SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4800
Practice Address - Country:US
Practice Address - Phone:507-328-6400
Practice Address - Fax:507-328-6263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11982251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health