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Organization

BRAINERD STATE HOSPITAL

Active
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Organization

BRAINERD STATE HOSPITAL

Active
Parent organization
STATE OF MINNESOTA
Organization subpart
Yes

Provider details

NPI number
Legal business name
STATE OF MINNESOTA
Authorized official
MR. ROD L KORNRUMPF (MENTAL HEALTH ADMIN OFFICER)
(763) 712-4010
Entity
Organization

Contact information

Practice address
11800 STATE HIGHWAY 18, BRAINERD, MN 56401-6250
(218) 828-2201
Mailing address
PO BOX 64979, SAINT PAUL, MN 55164-0979
(651) 431-3691
(651) 431-7505

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
331059
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
087058701
MN
Enumeration date
06/01/2006
Last updated
11/18/2008
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