Organization
ADULT, CHILD & FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL GRONNEBERG MS, LP (PARTNER)
(507) 387-3777
Entity
Organization
Contact information
Practice address
730 S FRONT ST, MANKATO, MN 56001-3803
(507) 387-3777
(507) 344-1726
Mailing address
730 S FRONT ST, MANKATO, MN 56001-3803
(507) 387-3777
(507) 344-1726
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08D47AD
BLUE CROSS BLUE SHIELD
MN
01
—
131689
UCARE
MN
01
—
39P46AD
BLUE CROSS BLUE SHIELD
MN
01
—
64Q88AD
BLUE CROSS BLUE SHIELD
MN
Enumeration date
07/29/2005
Last updated
07/21/2022
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