Provider Demographics
NPI:1598323453
Name:REFINE SERVICE COORDINATION PLLC
Entity Type:Organization
Organization Name:REFINE SERVICE COORDINATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:507-210-8695
Mailing Address - Street 1:512 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MN
Mailing Address - Zip Code:55049-9568
Mailing Address - Country:US
Mailing Address - Phone:507-210-8695
Mailing Address - Fax:
Practice Address - Street 1:512 4TH ST SW
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MN
Practice Address - Zip Code:55049-9568
Practice Address - Country:US
Practice Address - Phone:507-210-8695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty