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General NPI Number Information
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NPI Number | 1508835133
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Entity Type | Organization
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Legal Business Name | ALLUMA, INC.
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 603 BRUCE ST
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City | CROOKSTON
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State | MN
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Zip | 56716
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Country | US
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Telephone | 218-281-3940
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Fax | 218-281-6261
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Provider Business Mailing Address
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Address Line | 603 BRUCE STREET PO BOX 603
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City | CROOKSTON
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State | MN
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Zip | 56716-0603
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Country | US
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Telephone | 218-281-3940
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Fax | 218-281-6261
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. SHAUNA R REITMEIER
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Credential | LGSW
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Telephone | 218-281-3940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 8017741MHC
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License Number State | MN
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