Provider Demographics
NPI:1588948723
Name:NORTHERN INTEGRATED HEALTH INC
Entity type:Organization
Organization Name:NORTHERN INTEGRATED HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-548-9340
Mailing Address - Street 1:12450 WAYZATA BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1926
Mailing Address - Country:US
Mailing Address - Phone:952-545-4241
Mailing Address - Fax:
Practice Address - Street 1:12450 WAYZATA BLVD STE 107
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1926
Practice Address - Country:US
Practice Address - Phone:952-545-4241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN INTEGRATED HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health