Organization
ST. JOSEPH'S MEDICAL CENTER
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health St. Joseph's-Lakeland Psychiatry Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
KEVIN BOREN (VP OF FINANCE)
(218) 786-1009
Entity
Organization
Contact information
Practice address
523 N 3RD ST, 4TH FLOOR, BRAINERD, MN 56401-3054
(218) 828-7394
(218) 828-3130
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 828-7394
(218) 828-3130
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
330736
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736045200
—
MN
Enumeration date
08/17/2006
Last updated
02/27/2024
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