Provider Demographics
NPI:1346304805
Name:COMMINTY BEHAVIORAL HEALTH HOSPITAL-COLD SPRING
Entity Type:Organization
Organization Name:COMMINTY BEHAVIORAL HEALTH HOSPITAL-COLD SPRING
Other - Org Name:CBHH-COLD SPRING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADULT MENTAL HEALTH ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:L
Authorized Official - Last Name:KORNRUMPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-431-5003
Mailing Address - Street 1:PO BOX 64979
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55164-0979
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:224 KRAYS MILL ROAD
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:MN
Practice Address - Zip Code:56320
Practice Address - Country:US
Practice Address - Phone:320-685-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN571108000Medicaid