Organization
INTEGRATED CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS ORIBAMISE (CEO)
(612) 986-4514
Entity
Organization
Contact information
Practice address
12254 67TH ST NE, ELK RIVER, MN 55330-6900
(612) 986-4514
Mailing address
12254 67TH ST NE, ELK RIVER, MN 55330-6900
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
08/03/2023
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