# INNOVIS HEALTH, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ESSENTIA HEALTH
- **Other names:** Essentia Health Lisbon Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043490790
- **Legal business name:** ESSENTIA HEALTH
- **Authorized official:** ALAN HURLEY (COO)
- **Authorized official phone:** (701) 364-7667

## Contact information

- **Practice address:** 819 MAIN ST, LISBON, ND 58054-4244
- **Practice address phone:** (701) 683-4134
- **Practice address fax:** (701) 683-4094
- **Mailing address:** PO BOX 1450 NW 7813, MINNEAPOLIS, MN 55485-7813
- **Mailing address phone:** (701) 253-5300
- **Mailing address fax:** (701) 253-5402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/10/2007
- **Last updated:** 03/01/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 716483300 | — | MN |