Provider Demographics
NPI:1659694172
Name:BEMIDJI AREA PROGRAM FOR RECOVERY INC. STEPS TO FREEDOM PROGRAM
Entity Type:Organization
Organization Name:BEMIDJI AREA PROGRAM FOR RECOVERY INC. STEPS TO FREEDOM PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-444-5155
Mailing Address - Street 1:403 4TH ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3196
Mailing Address - Country:US
Mailing Address - Phone:218-444-5155
Mailing Address - Fax:218-333-3921
Practice Address - Street 1:626 MINNESOTA AVE NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3037
Practice Address - Country:US
Practice Address - Phone:218-444-5155
Practice Address - Fax:218-333-3921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1056317-1-CDT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7J00BEOtherBLUECROSS BLUE SHIELD
MN10006646OtherPRIMEWEST HEALTH