Organization
CENTRAL MINNESOTA MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BARAGA PH.D, LP (EXECUTIVE DIRECTOR)
(320) 252-5010
Entity
Organization
Contact information
Practice address
308 12TH AVE S, BUFFALO, MN 55313-2321
(763) 682-4400
(763) 682-1353
Mailing address
1321 13TH ST N, SAINT CLOUD, MN 56303-2613
(320) 252-5010
(320) 203-1855
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
807286-5-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
492319700
PROVIDER NUMBERE
MN
Enumeration date
04/03/2007
Last updated
07/21/2008
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