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Contact Information

CLAY COUNTY
715 11TH ST N
STE 303
MOORHEAD, MN56560-2083
 Phone: 218-299-7301
 Fax: 218-299-5795
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Health

163WC1500X
 

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for CLAY COUNTY · (Female)

NPI # 1114142569
Status Active
Credentials
Entity Individual
Enumeration date 04/13/2007
Last updated 01/03/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN Medicaid 427753800
  • MN Other 4C45CL BLUE PLUS DETOX PROVIDER
  • MN Other 8G510CL BLUE PLUS PROVIDER ID
  • MN Other 8300104 MEDICA PMAP PROVIDER
  • MN Other 5060753 MEDICA UBH PROVIDER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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