Provider Demographics
NPI:1003006917
Name:NEIGHBORHOOD COUNSELING CENTER OF WADENA, INC
Entity Type:Organization
Organization Name:NEIGHBORHOOD COUNSELING CENTER OF WADENA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-631-1714
Mailing Address - Street 1:720 COMMERCE RD
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347-1693
Mailing Address - Country:US
Mailing Address - Phone:320-732-3344
Mailing Address - Fax:
Practice Address - Street 1:720 COMMERCE RD
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-1693
Practice Address - Country:US
Practice Address - Phone:320-732-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD COUNSELING CENTER OF WADENA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health