Organization
MINNEWASKA AREA SCHOOLS #2149
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY F OHL (SUPERINTENDENT OF SCHOOLS)
(320) 239-4820
Entity
Organization
Contact information
Practice address
500 JOHN ST, MINNEWASKA AREA SCHOOLS DAY TREATMENT PROGRAM, STARBUCK, MN 56381
(320) 239-2257
(320) 239-1420
Mailing address
25122 STATE HWY 28, GLENWOOD, MN 56334
(320) 239-4800
(320) 239-1360
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050321002
PRIMEWEST HEALTH SYSTEMS
MN
01
—
218GIMI
BLUE CROSS BLUE SHIELD
MN
05
—
877946500
—
MN
Enumeration date
11/29/2006
Last updated
08/22/2020
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