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Organization

ADDICTIONS & STRESS CLINIC

Active
Other names
ASC PSYCHOLOGICAL SERVICES
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GEORGE V KOMARIDIS PH.D., LP (CLINICAL DIRECTOR)
(507) 345-4679
Entity
Organization

Contact information

Practice address
12 CIVIC CENTER PLZ, SUITE 2090, MANKATO, MN 56001-7781
(507) 345-4679
(507) 345-8685
Mailing address
12 CIVIC CENTER PLZ, SUITE 2090, MANKATO, MN 56001-7781
(507) 345-4679
(507) 345-8685

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LP1673
MN

Other

Enumeration date
08/25/2011
Last updated
08/25/2011
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