Healthcare Provider Details

I. General information

NPI: 1194790733
Provider Name (Legal Business Name): HUMAN DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 E 1ST ST
DULUTH MN
55805-2407
US

IV. Provider business mailing address

1401 E 1ST ST
DULUTH MN
55805-2407
US

V. Phone/Fax

Practice location:
  • Phone: 218-728-4491
  • Fax: 218-728-4404
Mailing address:
  • Phone: 218-728-4491
  • Fax: 218-728-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN HATFIELD
Title or Position: CHIEF EXECUTIVE DIRECTOR
Credential: MSW, LICSW, LADC
Phone: 218-728-4491