Organization
HENNEPIN HEALTHCARE SYSTEMS, INC.
Active
Other names
HCMC Psychiatry Crisis Residential
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK HOLLINGS (CHIEF FINANCIAL OFFICER)
(612) 873-5340
Entity
Organization
Contact information
Practice address
3633 CHICAGO AVE, SOUTH, MINNEAPOLIS, MN 55407-2603
(612) 873-3000
Mailing address
701 PARK AVE, P1-REIMBURSEMENT, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407897309
HENNEPIN COUNTY MEDICAL CENTER'S NPI
MN
Enumeration date
10/27/2016
Last updated
10/27/2016
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