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Organization

MODERN MOJO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONYA MARIE ZIMMERMAN (OFFICE MANAGER)
(218) 999-7750
Entity
Organization

Contact information

Practice address
28 NW 4TH ST, SUITE A, GRAND RAPIDS, MN 55744-2714
(218) 999-7750
Mailing address
28 NW 4TH ST, SUITE A, GRAND RAPIDS, MN 55744-2714
(218) 999-7750

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
02/03/2017
Last updated
03/08/2023
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