| Eagle Vista Ranch | |
|
16150 Golden Eagle Ct Nw Bemidji MN 56601-7111 | |
| (218) 760-0656 | |
| Not Available |
| Full Name | Eagle Vista Ranch |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 16150 Golden Eagle Ct Nw, Bemidji, Minnesota |
| Authorized Official Name and Position | Elizabeth Anne Letson (OWNER/FOUNDER AND LPC) |
| Authorized Official Contact | 2187600656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Vista Ranch 16150 Golden Eagle Ct Nw Bemidji MN 56601-7111 Ph: (218) 760-0656 | Eagle Vista Ranch 16150 Golden Eagle Ct Nw Bemidji MN 56601-7111 Ph: (218) 760-0656 |
| NPI Number | 1861893547 |
|---|---|
| Provider Enumeration Date | 09/11/2014 |
| Last Update Date | 09/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861893547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 01258 (Minnesota) | Primary |
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