Organization
DIVINE HOPE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI KAY HANSON LADC (ADMINISTRATOR)
(320) 231-9763
Entity
Organization
Contact information
Practice address
328 3RD ST SW, WILLMAR, MN 56201-3475
(320) 231-9763
(320) 235-0334
Mailing address
328 3RD ST SW, WILLMAR, MN 56201-3475
(320) 231-9763
(320) 235-0334
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1053421
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1I52DI
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/09/2009
Last updated
06/08/2012
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