Healthcare Provider Details

I. General information

NPI: 1205957610
Provider Name (Legal Business Name): HUMAN DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 WEST HWY 61 P.O. BOX 847
GRAND MARAIS MN
55604-0847
US

IV. Provider business mailing address

1401 E 1ST ST
DULUTH MN
55805-2407
US

V. Phone/Fax

Practice location:
  • Phone: 218-387-9444
  • Fax: 218-387-9435
Mailing address:
  • Phone: 218-728-4491
  • Fax: 218-728-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number8534482
License Number StateMN

VIII. Authorized Official

Name: JAMES GETCHELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 218-728-4491