Organization
NORTHLAND COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH GREGORY WALKER (CHIEF EXECUTIVE OFFICER)
(218) 313-1312
Entity
Organization
Contact information
Practice address
900 5TH ST, INTERNATIONAL FALLS, MN 56649-2254
(218) 283-3406
Mailing address
215 SE 2ND AVE, GRAND RAPIDS, MN 55744-3615
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
801758-1-MHC
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
894755400
—
MN
Enumeration date
12/22/2011
Last updated
12/22/2011
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