Organization
NORTHERN PINES MENTAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA L VAUGHN (EXECUTIVE DIRECTOR)
(320) 632-6647
Entity
Organization
Contact information
Practice address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(218) 821-7818
Mailing address
PO BOX 367, LITTLE FALLS, MN 56345-0367
(320) 632-6647
(320) 639-0014
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
09635
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767215200
—
MN
Enumeration date
03/06/2007
Last updated
12/02/2019
Update your record
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