Organization Name:  CLIENT COMMUNITY SERVICES, INC.


Practice Location:
826 5TH AVE  WORTHINGTON, MN 56187 US
Tel: 507-376-3171  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
X	251C00000X	Agencies Day Training, Developmentally Disabled Services	MN	801983-2-SILS
X	315P00000X	Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded	MN	802803-1-RS
X	320900000X	Residential Treatment Facilities Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities	MN	1013799-3-WS
X	320900000X	Residential Treatment Facilities Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities	MN	802834-3-WS
X	320900000X	Residential Treatment Facilities Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities	MN	804586-3-WS
X	320900000X	Residential Treatment Facilities Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities	MN	802833-3-WS

Other Provider Identifiers:

Issuer	Number	State	Type
MN DHS PROVIDER NUMBER	2436256	MN	01
MN DHS PROVIDER NUMBER	0595209	MN	01
DHS PROVIDER NUMBER	0733211	MN	01
DHS PROVIDER NUMBER	4697278	MN	01
MN DHS PROVIDER NUMBER	7640200	MN	01
MN DHS PROVIDER NUMBER	0488437	MN	01
MN DHS PROVIDER NUMBER	6540180	MN	01
MN DHS PROVIDER NUMBER	6876773	MN	01
MN DHS PROVIDER NUMBER	7573201	MN	01
MN DHS PROVIDER NUMBER	1058207	MN	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin