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Organization
GOOD STATE OF MIND AND MEDICAL CANNABIS PSYCHIATRIC CLINIC
Active
Organization
GOOD STATE OF MIND AND MEDICAL CANNABIS PSYCHIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT MATANGA (OWNER- PMHNP-BC)
(763) 516-4476
Entity
Organization
Contact information
Practice address
19427 136TH AVE N, ROGERS, MN 55374-4834
(763) 516-4476
Mailing address
19427 136TH AVE N, ROGERS, MN 55374-4834
(763) 516-4476
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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