Organization
LUTHERAN SOCIAL SERVICE OF MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL VANDERWALL (ASSOCIATE VICE PRESIDENT)
18005825260
Entity
Organization
Contact information
Practice address
211 HOLMES ST W, DETROIT LAKES, MN 56501-3023
(218) 847-0629
Mailing address
39400 MOONLIGHT BAY TRL, PELICAN RAPIDS, MN 56572-7546
(218) 863-2741
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13632
MN
Other
Enumeration date
10/19/2006
Last updated
08/22/2020
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