Provider Demographics
NPI:1912216540
Name:NOBLES COUNTY JAIL
Entity Type:Organization
Organization Name:NOBLES COUNTY JAIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:JAIL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MONETTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERKEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-295-5356
Mailing Address - Street 1:1530 AIRPORT ROAD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187
Mailing Address - Country:US
Mailing Address - Phone:507-295-5356
Mailing Address - Fax:
Practice Address - Street 1:1530 AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187
Practice Address - Country:US
Practice Address - Phone:507-295-5356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health