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General NPI Number Information
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NPI Number | 1467239533
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Entity Type | Organization
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Legal Business Name | MEADOWS CENTER FOR MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 3737 40TH AVE NW
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City | ROCHESTER
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State | MN
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Zip | 55901-1772
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Country | US
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Telephone | 507-288-6978
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Fax |
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Provider Business Mailing Address
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Address Line | 3737 40TH AVE NW
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City | ROCHESTER
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State | MN
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Zip | 55901-1772
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Country | US
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Telephone | 507-288-6978
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | HEATHER GRACE CRUZ
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Credential | MA, LPCC
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Telephone | 507-288-6978
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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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