=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417822297
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MH HEALTH CARE SERVICES, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2025
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2505 WILLMAR AVE SW
-----------------------------------------------------
City | WILLMAR
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56201-2711
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-263-4149
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1433
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03802-1433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-434-3255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR. VP CORPORATE MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. TERRY LAYMAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 866-434-3255
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------