Healthcare Provider Details

I. General information

NPI: 1851396402
Provider Name (Legal Business Name): COUNTY OF TODD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 2ND AVE S
LONG PRAIRIE MN
56347-1608
US

IV. Provider business mailing address

212 2ND AVE S
LONG PRAIRIE MN
56347-1608
US

V. Phone/Fax

Practice location:
  • Phone: 320-732-4500
  • Fax: 320-732-4445
Mailing address:
  • Phone: 320-732-4500
  • Fax: 320-732-4445

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 TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number326500
License Number StateMN

VIII. Authorized Official

Name: JACQUELYN R OCH
Title or Position: DIRECTOR
Credential: PHN
Phone: 320-732-4500