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General NPI Number Information
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NPI Number | 1457157109
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Entity Type | Organization
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Legal Business Name | COMBAT MENTAL HEALTH 2 LLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 121 1ST AVE SE
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City | HUTCHINSON
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State | MN
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Zip | 55350-2514
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Country | US
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Telephone | 320-200-9499
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Fax | 320-295-7898
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Provider Business Mailing Address
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Address Line | 450 MOOERS AVE SE
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City | COKATO
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State | MN
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Zip | 55321-4295
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Country | US
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Telephone | 320-405-3021
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HEATHER KAY PERERVA
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Credential | MS, LMFT
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Telephone | 320-200-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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