Provider Demographics
NPI:1780382184
Name:SOUTH METRO COMMUNITY SERVICES
Entity type:Organization
Organization Name:SOUTH METRO COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERGET
Authorized Official - Suffix:
Authorized Official - Credentials:ADC-T/ CPRS
Authorized Official - Phone:952-955-9399
Mailing Address - Street 1:13001 COUNTY ROAD 5
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1440 DUCKWOOD DR STE 500
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1399
Practice Address - Country:US
Practice Address - Phone:952-955-9399
Practice Address - Fax:952-395-3553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty