Organization
UPPER MISSISSIPPI MENTAL HEALTH CENTER, INC
Active
Other names
SAME
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI J. MILLER (OFFICE MANAGER)
(218) 751-3280
Entity
Organization
Contact information
Practice address
626 MINNESOTA AVE NW, BEMIDJI, MN 56601-3037
(218) 751-3280
Mailing address
722 15TH ST NW, P.O. BOX 640, BEMIDJI, MN 56601-2528
(218) 751-3280
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1026450-1-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
387142800
CONSOLIDATED FUNDING
MN
Enumeration date
05/07/2008
Last updated
05/07/2008
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