NPI | 1780043257 |
---|---|
Doing Business As | ESSENTIA HEALTH 52ND AVENUE CLINIC |
Entity Type | Organization |
Authorized Contact | ALAN J HURLEY COO 701-364-7667 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 207Q00000X Family Medicine |
261Q00000X Clinic/Center | |
Enumeration Date | 2016-02-12 |
Last Update Date | 2024-03-01 |