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Organization
FIVE COUNTY MENTAL HEALTH CENTER
Active
Organization
FIVE COUNTY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS SHROYER (EXECUTIVE DIRECTOR)
(320) 396-3333
Entity
Organization
Contact information
Practice address
521 BROADWAY AVENUE NORTH, FIVE COUNTY MENTAL HEALTH CENTER BRAHAM, BRAHAM, MN 55006
(320) 396-3333
(320) 396-3363
Mailing address
PO BOX 287, 521 BROADWAY AVENUE NORTH, BRAHAM, MN 55006
(320) 396-3333
(320) 396-3363
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
800826-1-MHC
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1150
HEALTH PARTNERS
MN
01
—
115857
UCARE
MN
01
—
204755100
MINNESOTA MEDICAL ASSISTA
MN
01
—
52337FI
BLUE CROSS BLUE SHIELD
MN
01
—
98982
PREFERRED ONE
MN
01
—
CS0088
RAILROAD MEDICARE
MN
Enumeration date
04/24/2007
Last updated
10/01/2007
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