Healthcare Provider Details

I. General information

NPI: 1487577318
Provider Name (Legal Business Name): ST LOUIS COUNTY PHHS DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W 2ND ST
DULUTH MN
55802-1404
US

IV. Provider business mailing address

320 W 2ND ST RM 401
DULUTH MN
55802-1404
US

V. Phone/Fax

Practice location:
  • Phone: 218-726-2000
  • Fax:
Mailing address:
  • Phone: 218-726-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JILL M. LARSON
Title or Position: FINANCE & OPERATIONS DIV DIRECTOR
Credential:
Phone: 218-726-2000