Organization
HIAWATHA VALLEY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE CONNERY (BOARD CHAIRMAN)
(507) 454-4341
Entity
Organization
Contact information
Practice address
611 BROADWAY AVE, SUITE 100, WABASHA, MN 55981-1988
(651) 565-2234
Mailing address
420 E SARNIA ST, WINONA, MN 55987-6365
(507) 454-4341
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
708556700
—
MN
Enumeration date
08/26/2008
Last updated
01/24/2019
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