FIVE COUNTY MENTAL HEALTH CENTER; NPI #1801015417

Contact Information

FIVE COUNTY MENTAL HEALTH CENTER

521 BROADWAY AVENUE NORTH
FIVE COUNTY MENTAL HEALTH CENTER BRAHAM
BRAHAM, MN 55006

Phone: 320-396-3333
Fax: 320-396-3363
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center

Indicates primary specialty

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NPI Profile & details for FIVE COUNTY MENTAL HEALTH CENTER

NPI # 1801015417

LBN Legal business name FIVE COUNTY MENTAL HEALTH CENTER

Authorized official THOMAS SHROYER - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/24/2007

Last updated 10/01/2007 - About 19 years ago

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 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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