Organization
SMDC MEDICAL CENTER
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Duluth-Amberwing Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
KEVIN BOREN (CFO)
(218) 786-1009
Entity
Organization
Contact information
Practice address
615 PECAN AVE, DULUTH, MN 55811
(218) 355-2100
(218) 355-2105
Mailing address
615 PECAN AVE, DULUTH, MN 55811
(218) 355-2100
(218) 355-2105
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033153895
—
MN
Enumeration date
09/04/2012
Last updated
02/27/2024
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