Provider Demographics
NPI:1497298293
Name:HEALTHSTAR / FIRST NATIONS
Entity Type:Organization
Organization Name:HEALTHSTAR / FIRST NATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:218-733-0707
Mailing Address - Street 1:4815 BURNING TREE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3800
Mailing Address - Country:US
Mailing Address - Phone:218-733-0707
Mailing Address - Fax:218-733-0717
Practice Address - Street 1:4815 BURNING TREE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3800
Practice Address - Country:US
Practice Address - Phone:218-733-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management