Organization
CHATTERS LUMBER INC
Active
Other names
Inner Science Health
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE EUGENE CHATTERS (CEO)
(612) 978-8191
Entity
Organization
Contact information
Practice address
4715 17TH AVE S, MINNEAPOLIS, MN 55407-3613
(612) 978-8191
Mailing address
4715 17TH AVE S, MINNEAPOLIS, MN 55407-3613
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
1069129-1-HCBS
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1069129
MN DHS LICENSE FACILITY ID
MN
Enumeration date
01/14/2014
Last updated
01/14/2014
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