| NPI | 1184277626 |
|---|---|
| Doing Business As | HEADWATERS ADULT DAY SERVICES |
| Entity Type | Organization |
| Authorized Contact | LAURA KATHERINE JOHNSON Executive Director 218-237-8518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |