Organization
WOODLAND CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHLEY KJOS (CEO)
(320) 235-4613
Entity
Organization
Contact information
Practice address
215 MILKYWAY ST S, COSMOS, MN 56228-7726
(320) 877-7220
(320) 877-7479
Mailing address
1125 6TH ST SE, WILLMAR, MN 56201-4675
(320) 235-4613
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
854855205
—
MN
Enumeration date
02/17/2020
Last updated
07/13/2020
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