Organization
CENTRAL MINNESOTA MENTAL HEALTH CENTER
Active
Other names
Great River ACT-St. Cloud
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J. BARAGA PH.D., LP (EXECUTIVE DIRECTOR)
(320) 252-5010
Entity
Organization
Contact information
Practice address
3333 W DIVISION ST, SUITE 217, SAINT CLOUD, MN 56301-4515
(320) 253-4136
(320) 253-4179
Mailing address
1321 13TH ST N, SAINT CLOUD, MN 56303-2613
(320) 252-5010
(320) 203-1855
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
800356-1-MHC
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024755301
—
MN
Enumeration date
05/11/2007
Last updated
12/16/2010
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