Healthcare Provider Details

I. General information

NPI: 1578980272
Provider Name (Legal Business Name): WILLIAMS COUNTY SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W BROADWAY STE 202
WILLISTON ND
58801-6056
US

IV. Provider business mailing address

110 W BROADWAY STE 202
WILLISTON ND
58801-6056
US

V. Phone/Fax

Practice location:
  • Phone: 701-774-6300
  • Fax:
Mailing address:
  • Phone: 701-774-6300
  • Fax:

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 Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LOIS REIERSON
Title or Position: COUNTY DIRECTOR IV
Credential:
Phone: 701-774-6300