CLIENT COMMUNITY SERVICES, INC.
Intermediate Care Facility, Mentally Retarded
Worthington, Minnesota
Provider NPI: 1730153693
Organization Information: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:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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 | 802833-3-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 | 802834-3-WS |
X | 320900000X | Residential Treatment Facilities Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MN | 1013799-3-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 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin