Organization
DAKOTA COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY NELSON (MANAGER ACCTS REC)
(651) 438-4363
Entity
Organization
Contact information
Practice address
1 MENDOTA RD W STE 300, WEST ST PAUL, MN 55118-4770
(651) 438-4539
(651) 438-4603
Mailing address
1590 HIGHWAY 55, HASTINGS, MN 55033-2343
(651) 438-4636
(651) 438-4603
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053409003
—
MN
05
—
1144494527
—
MN
05
—
1285722272
—
MN
05
—
142127620
—
MN
05
—
1548424658
—
MN
Enumeration date
05/27/2010
Last updated
08/25/2014
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