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General NPI Number Information
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NPI Number | 1013152776
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Entity Type | Organization
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Legal Business Name | DES MOINES VALLEY HEALTH AND HUMAN SERVICES
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 407 5TH ST
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City | JACKSON
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State | MN
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Zip | 56143-9588
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Country | US
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Telephone | 507-847-4000
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Fax | 507-847-5616
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | WINDOM
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State | MN
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Zip | 56101-9998
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Country | US
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Telephone | 507-831-1891
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Fax | 507-831-0126
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Authorized Official
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Title or Position | DIR OF BUSINESS OPER
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Name | MR. ROBERT KRAMER
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Credential |
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Telephone | 507-831-1891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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