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Organization

ELEMENTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAIME KRUPA (AUTHORIZED AGENT)
(320) 282-8178
Entity
Organization

Contact information

Practice address
305 4TH AVE S, SARTELL, MN 56377-4729
(320) 282-8178
Mailing address
305 4TH AVE S, SARTELL, MN 56377-4729

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
04/24/2022
Last updated
04/24/2022
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