Provider Demographics
NPI:1659822286
Name:FLOODWOOD SERVICES & TRAINING, INC.
Entity Type:Organization
Organization Name:FLOODWOOD SERVICES & TRAINING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:LAMPING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-476-2230
Mailing Address - Street 1:601 ASH ST
Mailing Address - Street 2:PO BOX 347
Mailing Address - City:FLOODWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55736-8177
Mailing Address - Country:US
Mailing Address - Phone:218-476-2230
Mailing Address - Fax:218-476-2317
Practice Address - Street 1:601 ASH ST
Practice Address - Street 2:
Practice Address - City:FLOODWOOD
Practice Address - State:MN
Practice Address - Zip Code:55736-8177
Practice Address - Country:US
Practice Address - Phone:218-476-2230
Practice Address - Fax:218-476-2317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1068035251V00000X
MN831010261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNM596060600OtherUMPI