Organization
UPPER MISSISSIPPI MENTAL HEALTH CENTER, INC.
Active
Other names
same
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTI J MILLER (OFFICE MANAGER)
(218) 751-3280
Entity
Organization
Contact information
Practice address
120 MAIN AVE N, PARK RAPIDS, MN 56470-1810
(218) 732-7266
Mailing address
120 MAIN AVE N, PARK RAPIDS, MN 56470-1810
(218) 732-7266
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1015165-1-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064997000
CONSOLIDATED FUNDING
MN
Enumeration date
05/07/2008
Last updated
05/07/2008
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