Organization
BECKER COUNTY
Active
Other names
Becker County Community Health
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY NELSON (DIRECTOR)
(218) 847-5628
Entity
Organization
Contact information
Practice address
712 MINNESOTA AVE, DETROIT LAKES, MN 56501-3035
(218) 847-5628
(218) 847-6738
Mailing address
712 MINNESOTA AVE, DETROIT LAKES, MN 56501-3035
(218) 847-5628
(218) 847-6738
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
163WC1500X
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084915400
—
MN
01
—
338K8BE
BLUE PLUS
MN
01
—
59-00258
MEDICA
MN
01
—
83-00119
MEDICA
MN
Enumeration date
10/16/2006
Last updated
04/21/2009
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