Organization Name: | NORTHERN PINES MENTAL HEALTH CENTER, INC. |
NPI Number: | 1013904051 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GLENN M ANDERSON (EXECUTIVE DIRECTOR) |
Mailing Address: | 1906 5th Ave Se Little Falls |
State: | MN US |
Postal Code: | 563453317 |
Phone Number: | 3206326647 |
Fax Number: | 3206329525 |
NPI Enumeration Date: | 10/04/2005 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | 1001061CDT |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |