Organization
MID-RANGE CHEMICAL DEPENDENCY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CLARK LADC (CLINICAL SUPERVISOR)
(218) 262-0860
Entity
Organization
Contact information
Practice address
522 E HOWARD ST STE 101, HIBBING, MN 55746-1714
(218) 262-0860
Mailing address
522 E HOWARD ST STE 101, HIBBING, MN 55746-1714
(218) 262-0860
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1061219
MN
Other
Enumeration date
02/02/2012
Last updated
04/18/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up