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Organization

MANKATO MENTAL HEALTH ASSOCIATES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DAWN MARIE ULRICH L.P. (DIRECTOR/PRESIDENT/CEO)
(507) 345-4448
Entity
Organization

Contact information

Practice address
209 S BROAD ST, SUITE C, MANKATO, MN 56001-3681
(507) 345-4448
(507) 625-1000
Mailing address
209 S BROAD ST, SUITE C, MANKATO, MN 56001-3681
(507) 345-4448
(507) 625-1000

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LP3697
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
602022400
MN
Enumeration date
09/11/2008
Last updated
09/11/2008
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