Healthcare Provider Details

I. General information

NPI: 1649391053
Provider Name (Legal Business Name): BRIGHTWATER HEALTH DBA HUMAN DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E 4TH ST
DULUTH MN
55805-2147
US

IV. Provider business mailing address

1401 E 1ST ST
DULUTH MN
55805-2407
US

V. Phone/Fax

Practice location:
  • Phone: 218-728-3931
  • Fax: 218-302-8728
Mailing address:
  • Phone: 218-728-4491
  • Fax: 218-730-2367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number8534482
License Number StateMN

VIII. Authorized Official

Name: BENJAMIN HATFIELD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 218-728-4491