Thunderbird-Wren House
LBN: Minnesota Indian Primary Residential Treatment Center, Inc.
Thunderbird-Wren House is an health care organization with primary practice located at 9302 Idaho Street , Duluth MN 55808. The organization recently has only one registered license in Other Service Providers / Lodging, which is considered as the primary health care specialty.
Minnesota Indian Primary Residential Treatment Center, Inc. can be contacted via phone (218) 727-7699, or through Mallery, James W via phone (218) 879-6731.
Contact Information
Primary practice address
9302 Idaho Street
Duluth MN 55808
Phone: (218) 727-7699
Fax: (218) 727-1476
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Lodging | 177F00000X | 8025091CDT | Minnesota |
| Other Service Providers / Lodging | 177F00000X |
Profile Details
| NPI number | 1588732762 |
|---|---|
| LBN Legal business name | Minnesota Indian Primary Residential Treatment Center, Inc. |
| DBA Doing business as | Thunderbird-Wren House |
| Authorized official | Mallery, James W |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 4th, 2006 |
| Last updated | May 8th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588732762 | NPPES |
| Minnesota | Other | 9594TH | BCBS OF MINNESOTA |
| Minnesota | MEDICAID | 786355100 | BCBS OF MINNESOTA |
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