Provider Demographics
NPI:1043468853
Name:BOIS FORTE HEALTH SERVICES
Entity Type:Organization
Organization Name:BOIS FORTE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER/FAMILY BASE
Authorized Official - Prefix:
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:WHITEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-757-3295
Mailing Address - Street 1:13071 NETT LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:NETT LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55771
Mailing Address - Country:US
Mailing Address - Phone:218-757-3295
Mailing Address - Fax:218-757-0222
Practice Address - Street 1:13071 NETT LAKE ROAD
Practice Address - Street 2:
Practice Address - City:NETT LAKE
Practice Address - State:MN
Practice Address - Zip Code:55771
Practice Address - Country:US
Practice Address - Phone:218-757-3295
Practice Address - Fax:218-757-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management