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General NPI Number Information
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NPI Number | 1598163503
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Entity Type | Organization
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Legal Business Name | GREATER MINNESOTA COMMUNITY SERVICES
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 819 30TH AVE S STE 102
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City | MOORHEAD
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State | MN
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Zip | 56560-5000
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Country | US
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Telephone | 218-979-3560
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Fax | 321-284-1080
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Provider Business Mailing Address
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Address Line | 819 30TH AVE S STE 102
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City | MOORHEAD
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State | MN
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Zip | 56560-5000
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Country | US
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Telephone | 218-979-3560
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Fax | 321-284-1080
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Authorized Official
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Title or Position | CEO
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Name | BENJAMIN L ERIE
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Credential |
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Telephone | 218-979-3560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 1078038
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License Number State | MN
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Taxonomy #2
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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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