Organization
KINGDOM PATHWAYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MICHAUD MDIV. (EXECUTIVE DIRECTOR)
(651) 387-8393
Entity
Organization
Contact information
Practice address
11825 BITTERSWEET ST NW, COON RAPIDS, MN 55433-2917
(763) 862-5336
(763) 862-5336
Mailing address
11825 BITTERSWEET ST NW, COON RAPIDS, MN 55433-2917
(763) 862-5336
(763) 862-5336
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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