Healthcare Provider Details

I. General information

NPI: 1487021572
Provider Name (Legal Business Name): CASS COUNTY SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 2ND AVE S
FARGO ND
58103-8226
US

IV. Provider business mailing address

1010 2ND AVE S
FARGO ND
58103-8226
US

V. Phone/Fax

Practice location:
  • Phone: 701-241-5765
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number4446
License Number StateND

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: FORREST AMMERMAN
Title or Position: DIRECTOR
Credential:
Phone: 701-239-6700