| Organization Name: | NORTH CENTRAL MINISTRY DEVELOPMENT CENTER, INC. |
| NPI Number: | 1164711735 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK ELMER SUNDBY (EXECUTIVE DIRECTOR) |
| Mailing Address: | 516 Mission House Ln New Brighton |
| State: | MN US |
| Postal Code: | 551122571 |
| Phone Number: | 6516365120 |
| Fax Number: | 6516365124 |
| NPI Enumeration Date: | 04/04/2011 |
| NPI Last Update Date: | 01/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP4223 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |