Provider Demographics
NPI:1508078502
Name:EPISCOPAL COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:EPISCOPAL COMMUNITY SERVICES, INC.
Other - Org Name:ARCHDEACON GILFILLAN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDEMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:612-874-8823
Mailing Address - Street 1:PO BOX 744
Mailing Address - Street 2:1741 15TH STREET NW
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56619-0744
Mailing Address - Country:US
Mailing Address - Phone:218-751-6553
Mailing Address - Fax:218-751-1846
Practice Address - Street 1:1741 15TH STREET NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56619-0744
Practice Address - Country:US
Practice Address - Phone:218-751-6553
Practice Address - Fax:218-751-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health