Healthcare Provider Details

I. General information

NPI: 1245628684
Provider Name (Legal Business Name): DUNN COUNTY SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 CENTRAL AVE NORTH
KILLDEER ND
58640
US

IV. Provider business mailing address

PO BOX 89
KILLDEER ND
58640-0089
US

V. Phone/Fax

Practice location:
  • Phone: 701-764-5385
  • Fax: 701-764-5070
Mailing address:
  • Phone: 701-764-5385
  • Fax: 701-764-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number2500
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number3682
License Number StateND

VIII. Authorized Official

Name: THOMAS HUNTER PICKEN
Title or Position: DIRECTOR
Credential:
Phone: 701-764-5385