Healthcare Provider Details

I. General information

NPI: 1912013848
Provider Name (Legal Business Name): SOUTH CENTRAL HUMAN RELATIONS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 LANDMARK DR.
OWATONNA MN
55060-5702
US

IV. Provider business mailing address

610 FLORENCE AVE
OWATONNA MN
55060-4704
US

V. Phone/Fax

Practice location:
  • Phone: 507-455-8100
  • Fax: 507-446-8056
Mailing address:
  • Phone: 507-451-2630
  • Fax: 507-455-8133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN J WHEELER
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, LICSW
Phone: 507-451-2630