Organization
INTERIM HEALTHCARE OF LAKE SUPERIOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARI JO JARVI (CONTROLLER)
(218) 722-0053
Entity
Organization
Contact information
Practice address
332 W SUPERIOR ST, SUITE 204, DULUTH, MN 55802
(218) 722-0053
(218) 722-0318
Mailing address
332 W SUPERIOR ST, SUITE 204, DULUTH, MN 55802
(218) 722-0053
(218) 722-0318
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
327241
MN
251E00000X
Home Health Agency
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109638
UCARE
MN
05
—
41529800
—
WI
01
—
59-00052
MEDICA
MN
01
—
8569IN
BLUE CROSS BLUE SHIELD
MN
05
—
96435590
—
MN
05
—
964355900
—
MN
Enumeration date
05/31/2005
Last updated
10/08/2019
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