Organization
LION YOUTH & COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH LONGFELLOW HANNA II LICSW (OWNER)
(320) 420-1272
Entity
Organization
Contact information
Practice address
807 DIVISION ST S, NORTHFIELD, MN 55057-2430
(320) 420-1272
(320) 240-6814
Mailing address
600 25TH AVE S STE 209, SAINT CLOUD, MN 56301-4866
(320) 420-1272
(320) 240-6814
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2571659
MN
Other
Enumeration date
04/02/2018
Last updated
02/05/2025
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