Provider Demographics
NPI:1609417757
Name:MH HEALTH CARE SERVICES, PC
Entity Type:Organization
Organization Name:MH HEALTH CARE SERVICES, PC
Other - Org Name:JOHNSON BROTHERS HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CORPORATE MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-727-6898
Mailing Address - Street 1:20 WINOOSKI FALLS WAY STE 475
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2277
Mailing Address - Country:US
Mailing Address - Phone:802-857-0400
Mailing Address - Fax:
Practice Address - Street 1:1145 HOMER ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3231
Practice Address - Country:US
Practice Address - Phone:612-426-3771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty