Organization
NORTHWESTERN MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL G WILSON LICSW (EXECUTIVE DIRECTOR)
(218) 281-3940
Entity
Organization
Contact information
Practice address
603 BRUCE ST, CROOKSTON, MN 56716-2914
(218) 281-3940
Mailing address
603 BRUCE ST, PO BOX 603, CROOKSTON, MN 56716-2914
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
19341
MN
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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