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General NPI Number Information
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NPI Number | 1477684041
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Entity Type | Organization
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Legal Business Name | KITTSON COUNTY
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 410 S 5TH ST SUITE 104
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City | HALLOCK
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State | MN
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Zip | 56728-4140
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Country | US
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Telephone | 218-843-2113
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Fax | 218-843-2020
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Provider Business Mailing Address
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Address Line | 410 S. 5TH ST. SUITE 104
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City | HALLOCK
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State | MN
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Zip | 56735-0104
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Country | US
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Telephone | 218-843-2113
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Fax | 218-843-2020
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Authorized Official
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Title or Position | HIPAA COORDINATOR
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Name | MR. GARY LEE RICE I
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Credential |
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Telephone | 218-843-2113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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