Healthcare Provider Details

I. General information

NPI: 1710212055
Provider Name (Legal Business Name): COUNTY OF SIBLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 8TH ST
GAYLORD MN
55334-0237
US

IV. Provider business mailing address

111 8TH ST PO BOX 237
GAYLORD MN
55334-0237
US

V. Phone/Fax

Practice location:
  • Phone: 507-237-4000
  • Fax: 507-237-4031
Mailing address:
  • Phone: 507-237-4000
  • Fax: 507-237-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: VICKI STOCK
Title or Position: DIRECTOR
Credential:
Phone: 507-237-4000