National Provider Identifier Database

FIVE COUNTY MENTAL HEALTH CENTER
Mental Health (Including Community Mental Health Center)


Contact Information

FIVE COUNTY MENTAL HEALTH CENTER
521 BROADWAY AVENUE NORTH
FIVE COUNTY MENTAL HEALTH CENTER BRAHAM
BRAHAM, MN55006
Phone: 320-396-3333
Fax: 320-396-3363
Website:
Specialty Taxonomy Code
* Mental Health (Including Community Mental Health Center) 261QM0801X

* Indicates primary specialty

NPI Profile & details for FIVE COUNTY MENTAL HEALTH CENTER

NPI Number 1801015417
Legal business name
LBN
FIVE COUNTY MENTAL HEALTH CENTER
Authorized official THOMAS SHROYER - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 04/24/2007
Last updated 10/01/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 800826-1-MHC
  • MN Other: 52337FI BLUE CROSS BLUE SHIELD
  • MN Other: 1150 HEALTH PARTNERS
  • MN Other: 204755100 MINNESOTA MEDICAL ASSISTA
  • MN Other: 98982 PREFERRED ONE
  • MN Other: CS0088 RAILROAD MEDICARE
  • MN Other: 115857 UCARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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