Provider Demographics
NPI:1558929539
Name:BEHAVIORAL HEALTH ADVOCACY SERVICES LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH ADVOCACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-251-4571
Mailing Address - Street 1:2907 CLEARWATER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-6191
Mailing Address - Country:US
Mailing Address - Phone:320-251-4571
Mailing Address - Fax:320-205-0930
Practice Address - Street 1:2907 CLEARWATER RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-6191
Practice Address - Country:US
Practice Address - Phone:320-251-4571
Practice Address - Fax:320-205-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health