Provider Demographics
NPI:1164190716
Name:CENTER FOR FAMILY AND MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:CENTER FOR FAMILY AND MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MASAHIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:SATO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPCC, LADC
Authorized Official - Phone:507-202-9186
Mailing Address - Street 1:1500 1ST AVE NE STE 201A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-4311
Mailing Address - Country:US
Mailing Address - Phone:507-218-8228
Mailing Address - Fax:
Practice Address - Street 1:1500 1ST AVE NE STE 201A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-4311
Practice Address - Country:US
Practice Address - Phone:507-218-8228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)