# CENTRAL MINNESOTA MENTAL HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great River ACT-St. Cloud
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639384043
- **Authorized official:** DAVID J. BARAGA PH.D., LP (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (320) 252-5010

## Contact information

- **Practice address:** 3333 W DIVISION ST, SUITE 217, SAINT CLOUD, MN 56301-4515
- **Practice address phone:** (320) 253-4136
- **Practice address fax:** (320) 253-4179
- **Mailing address:** 1321 13TH ST N, SAINT CLOUD, MN 56303-2613
- **Mailing address phone:** (320) 252-5010
- **Mailing address fax:** (320) 203-1855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 800356-1-MHC | MN | Yes |

## Other

- **Enumeration date:** 05/11/2007
- **Last updated:** 12/16/2010