Organization
ZUMBRO VALLEY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LYNN LEE (CHIEF OPERATING OFF)
(507) 535-5715
Entity
Organization
Contact information
Practice address
343 WOOD LAKE DRIVE SE, ROCHESTER, MN 55904
(507) 289-2089
(507) 289-2327
Mailing address
343 WOOD LAKE DRIVE SE, ROCHESTER, MN 55904
(507) 289-2089
(507) 289-2327
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
802789-1-MHC
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275055400
—
MN
05
—
275055401
—
MN
05
—
288625100
—
MN
05
—
300645100
—
MN
01
—
39853ZU
BCBS - MH
MN
01
—
9002ZU
BCBS - CD TREATMENT
MN
01
—
9823ZU
BCBS - DETOX
MN
Enumeration date
11/21/2006
Last updated
03/24/2015
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