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Organization
BOREALIS HEALTH PLLC
Active
Organization
BOREALIS HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIE JON BATA (OWNER)
(218) 297-1900
Entity
Organization
Contact information
Practice address
813 S POKEGAMA AVE STE A, GRAND RAPIDS, MN 55744-3934
(218) 297-1900
Mailing address
813 S POKEGAMA AVE STE A, GRAND RAPIDS, MN 55744-3934
(218) 297-1900
(218) 203-4788
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184419228
—
MN
Enumeration date
04/10/2025
Last updated
04/14/2026
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