Healthcare Provider Details

I. General information

NPI: 1588878359
Provider Name (Legal Business Name): EPISCOPAL COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 15TH STREET NW
BEMIDJI MN
56619-0744
US

IV. Provider business mailing address

PO BOX 744 1741 15TH STREET NW
BEMIDJI MN
56619-0744
US

V. Phone/Fax

Practice location:
  • Phone: 218-751-6553
  • Fax: 218-751-1846
Mailing address:
  • Phone: 218-751-6553
  • Fax: 218-751-1846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number800111-3-CRF
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number800111-3-CRF
License Number StateMN

VIII. Authorized Official

Name: MR. FRANK VARDEMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 612-874-8823