Provider Demographics
NPI:1033866744
Name:HARMAN BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:HARMAN BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MANWA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:612-532-6404
Mailing Address - Street 1:11241 MISSISSIPPI DR N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3575
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11241 MISSISSIPPI DR N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3575
Practice Address - Country:US
Practice Address - Phone:612-532-6404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)