| Organization Name: | BEHAVIORAL HEALTH ASSOCIATES, LTD. |
| NPI Number: | 1104128156 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY LUNDQUIST (ADMINISTRATIVE DIRECTOR) |
| Mailing Address: | 1132 28th Ave S Suite 105a Moorhead |
| State: | MN US |
| Postal Code: | 565604420 |
| Phone Number: | 8002469036 |
| Fax Number: | 8886884095 |
| NPI Enumeration Date: | 11/24/2010 |
| NPI Last Update Date: | 11/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TM1800X |
| License Number: | A470016300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Mental Retardation & Developmental Disabilities |
| Taxonomy Definition: | |