Basic Information
| Provider Information | |||||||||
| NPI: | 1184877359 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEMIDJI AREA PROGRAM FOR RECOVERY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 403 4TH ST NW | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BEMIDJI | ||||||||
| State: | MN | ||||||||
| PostalCode: | 566013142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2184445155 | ||||||||
| FaxNumber: | 2183333921 | ||||||||
| Practice Location | |||||||||
| Address1: | 403 4TH ST NW | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BEMIDJI | ||||||||
| State: | MN | ||||||||
| PostalCode: | 566013142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2184445155 | ||||||||
| FaxNumber: | 2183333921 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2008 | ||||||||
| LastUpdateDate: | 10/31/2008 | ||||||||
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| AuthorizedOfficialLastName: | BUSCHER | ||||||||
| AuthorizedOfficialFirstName: | TERRI | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2184445155 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 1051960 | MN | Y | Agencies | Community/Behavioral Health |
No ID Information.