| Fdl Human Services Behavioral Health | |
|
927 Trettel Ln Cloquet MN 55720-1345 | |
| (218) 879-1227 | |
| Not Available |
| Full Name | Fdl Human Services Behavioral Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 927 Trettel Ln, Cloquet, Minnesota |
| Authorized Official Name and Position | Jennifer Dupuis (ASSOCIATE DIRECTOR) |
| Authorized Official Contact | 2188791227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fdl Human Services Behavioral Health 927 Trettel Ln Cloquet MN 55720-1345 Ph: (218) 879-1227 | Fdl Human Services Behavioral Health 927 Trettel Ln Cloquet MN 55720-1345 Ph: (218) 879-1227 |
| NPI Number | 1053772087 |
|---|---|
| Provider Enumeration Date | 03/18/2016 |
| Last Update Date | 06/23/2020 |
| Certification Date | 06/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053772087 | NPI | - | NPPES |
| 666815101 | Medicaid | MN | |
| 8F27FO | Other | MN | BCBS AODA |
| 666815100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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