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General NPI Number Information
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NPI Number | 1801961263
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Entity Type | Organization
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Legal Business Name | ZUMBRO VALLEY HEALTH CENTER
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 343 WOOD LAKE DRIVE SE
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City | ROCHESTER
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State | MN
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Zip | 55904
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Country | US
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Telephone | 507-289-2089
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Fax | 507-289-2327
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Provider Business Mailing Address
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Address Line | 343 WOOD LAKE DRIVE SE
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City | ROCHESTER
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State | MN
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Zip | 55904
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Country | US
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Telephone | 507-289-2089
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Fax | 507-289-2327
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Authorized Official
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Title or Position | CHIEF OPERATING OFF
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Name | TRACY LYNN LEE
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Credential |
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Telephone | 507-535-5715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 802789-1-MHC
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License Number State | MN
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