Provider Demographics
NPI:1407949167
Name:THE HILLS YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:THE HILLS YOUTH AND FAMILY SERVICES
Other - Org Name:CAMBIA HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEROLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-623-6425
Mailing Address - Street 1:4321 ALLENDALE AVENUE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-1562
Mailing Address - Country:US
Mailing Address - Phone:218-728-7500
Mailing Address - Fax:218-728-7501
Practice Address - Street 1:4321 ALLENDALE AVENUE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803
Practice Address - Country:US
Practice Address - Phone:218-728-7500
Practice Address - Fax:218-728-7408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN040978200261QM0855X
MN1036983-1-CRF322D00000X, 322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN262L1WOOtherBCBS OF MN
MN136305OtherUCARE MINNESOTA
MN8467273OtherUBH/MEDICA SELECT CARE
MN040978200Medicaid
MN1042152OtherPREFERREDONE