Organization
NORTHERN PINES MENTAL HEALTH CENTER, INC.
Active
Other names
Northern Pines Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA VAUGHN (EXECUTIVE DIRECTOR)
(320) 639-2025
Entity
Organization
Contact information
Practice address
1906 5TH AVE SE, LITTLE FALLS, MN 56345-3317
(320) 632-6647
(320) 632-9525
Mailing address
PO BOX 367, 1906 5TH AVE SE, LITTLE FALLS, MN 56345-0367
(320) 632-6642
(320) 632-9525
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
8017541MHC
MN
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
1001061CDT
MN
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
10102841CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007444000
—
MN
01
—
126039
UCARE MINNESOTA
MN
05
—
195354100
—
MN
01
—
4788N0
BCBS OF MINNESOTA
MN
01
—
6369
HEALTH PARTNERS
MN
01
—
83367N0
BCBS OF MINNESOTA
MN
05
—
834755700
—
MN
01
—
98224
PREFERRED ONE
MN
Enumeration date
10/04/2005
Last updated
09/24/2024
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