Organization
FATHERS RISE TOGETHER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAQUANA LATRICE MCENTYRE (PRESIDENT)
(218) 390-9204
Entity
Organization
Contact information
Practice address
319 N 22ND AVE WEST, DULUTH, MN 55807
(218) 390-9204
Mailing address
319 N 21ST AVE W, DULUTH, MN 55806-1626
(218) 390-9204
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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