Healthcare Provider Details

I. General information

NPI: 1194008060
Provider Name (Legal Business Name): SHERBURNE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13880 BUSINESS CENTER DR NW
ELK RIVER MN
55330-1692
US

IV. Provider business mailing address

13880 BUSINESS CENTER DR NW SUITE 100
ELK RIVER MN
55330-1692
US

V. Phone/Fax

Practice location:
  • Phone: 763-765-4011
  • Fax: 763-765-4096
Mailing address:
  • Phone: 763-765-4025
  • Fax: 763-765-4096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY EHNES
Title or Position: FISCAL SUPERVISOR
Credential:
Phone: 763-765-4025