Provider Demographics
NPI:1295814796
Name:STELLHER HUMAN SERVICES, INC.
Entity Type:Organization
Organization Name:STELLHER HUMAN SERVICES, INC.
Other - Org Name:LAPORTE CHEMICAL HEALTH PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACKELEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:218-751-5919
Mailing Address - Street 1:514 BELTRAMI AVE NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3010
Mailing Address - Country:US
Mailing Address - Phone:218-444-2845
Mailing Address - Fax:218-444-2847
Practice Address - Street 1:315 MAIN ST W
Practice Address - Street 2:LAPORTE SCHOOL DISTRICT #306
Practice Address - City:LAPORTE
Practice Address - State:MN
Practice Address - Zip Code:56461-4659
Practice Address - Country:US
Practice Address - Phone:218-444-2845
Practice Address - Fax:218-444-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1042735-1-CDT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health