Provider Demographics
NPI:1720457401
Name:INTER-COUNTY COMMUNITY COUNCIL
Entity Type:Organization
Organization Name:INTER-COUNTY COMMUNITY COUNCIL
Other - Org Name:HEAD START
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-796-5144
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:207 MAIN STREET
Mailing Address - City:OKLEE
Mailing Address - State:MN
Mailing Address - Zip Code:56742
Mailing Address - Country:US
Mailing Address - Phone:218-796-5144
Mailing Address - Fax:218-796-5175
Practice Address - Street 1:207 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OKLEE
Practice Address - State:MN
Practice Address - Zip Code:56742
Practice Address - Country:US
Practice Address - Phone:218-796-5144
Practice Address - Fax:218-796-5175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable