Organization
AGATE BAY PROFESSIONALS CHEMICAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH CLARK MSW, LICSW, LADC (COUNSELOR & THERAPIST)
(218) 830-8085
Entity
Organization
Contact information
Practice address
227 7TH ST, TWO HARBORS, MN 55616-1530
(218) 830-8085
Mailing address
227 7TH ST, TWO HARBORS, MN 55616-1530
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/03/2013
Last updated
01/31/2022
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