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Organization
CENTRAL MINNESOTA MENTAL HEALTH CENTER
Active
Organization
CENTRAL MINNESOTA MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BARAGA PH.D, LP (EXECUTIVE DIRECTOR)
(320) 252-5010
Entity
Organization
Contact information
Practice address
308 12TH AVE S, BUFFALO, MN 55313-2321
(763) 682-4400
(763) 682-1353
Mailing address
1321 13TH ST N, SAINT CLOUD, MN 56303-2613
(320) 252-5010
(320) 203-1855
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
807286-5-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
492319700
PROVIDER NUMBERE
MN
Enumeration date
04/03/2007
Last updated
07/21/2008
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