| Organization Name: | CENTRACARE CLINIC |
| NPI Number: | 1346531340 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS M. FELDHEGE (TREASURER/DIRECTOR OF FINANCE) |
| Mailing Address: | 433 Elm St N Centracare Clinic - Sauk Centre Sauk Centre |
| State: | MN US |
| Postal Code: | 563781052 |
| Phone Number: | 3203526591 |
| Fax Number: | 3203525164 |
| NPI Enumeration Date: | 04/25/2011 |
| NPI Last Update Date: | 12/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |