Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Minnesota Indian Primary Residential Treatment Center, Inc

Organization Lodging Provider · NPI 1588732762

Minnesota Indian Primary Residential Treatment Center, Inc is a Lodging Provider in Duluth, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9302 Idaho St
Duluth, MN 55808
Phone: (218) 727-7699
Fax: (218) 727-1476
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Lodging Provider (primary) Taxonomy 177F00000X
Lodging Provider Taxonomy 177F00000X · Licence 8025091CDT (MN)

Record details

NPI number1588732762
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Mallery — Administrator · (218) 879-6731
Other names Thunderbird-Wren House; Thunderbird-Wren House
NPI enumeratedDecember 4, 2006
Last updated in NPPESMay 8, 2023
Certification dateMay 8, 2023
Mailing addressPo Box 66, Sawyer, MN 55780

Other providers in Duluth