Provider Demographics
NPI:1558695957
Name:BELTRAMI AREA SERVICE COLLABORATIVE
Entity Type:Organization
Organization Name:BELTRAMI AREA SERVICE COLLABORATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GRUNDMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-333-8191
Mailing Address - Street 1:701 MINNESOTA AVE NW STE 235
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3179
Mailing Address - Country:US
Mailing Address - Phone:218-333-8191
Mailing Address - Fax:218-333-8193
Practice Address - Street 1:701 MINNESOTA AVE NW STE 235
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3179
Practice Address - Country:US
Practice Address - Phone:218-333-8191
Practice Address - Fax:218-333-8193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management