Healthcare Provider Details

I. General information

NPI: 1013152776
Provider Name (Legal Business Name): DES MOINES VALLEY HEALTH AND HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 4TH ST, BLDG 4
JACKSON MN
56143
US

IV. Provider business mailing address

PO BOX 67
JACKSON MN
56143-0067
US

V. Phone/Fax

Practice location:
  • Phone: 507-847-4000
  • Fax: 507-847-5616
Mailing address:
  • Phone: 507-847-4000
  • Fax: 507-847-5616

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMN

VIII. Authorized Official

Name: MS. NATANE SADUSKY
Title or Position: FISCAL MANAGER
Credential:
Phone: 507-847-6899