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General NPI Number Information
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NPI Number | 1598177156
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Entity Type | Organization
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Legal Business Name | MCKENZIE COUNTY SOCIAL SERVICES
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 201 5TH ST NW UNIT 790
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City | WATFORD CITY
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State | ND
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Zip | 58854-7118
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Country | US
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Telephone | 701-444-3661
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Fax | 701-444-6436
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Provider Business Mailing Address
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Address Line | 201 5TH ST NW UNIT 790
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City | WATFORD CITY
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State | ND
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Zip | 58854-7118
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Country | US
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Telephone | 701-444-3661
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Fax | 701-444-6436
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Authorized Official
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Title or Position | COUNTY DIRECTOR
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Name | MRS. DESIREE SORENSON
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Credential | LSW
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Telephone | 701-444-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 251B00000X
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License Number State | ND
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