Provider Demographics
NPI:1922337344
Name:CENTRAL MINNESOTA GROUP HEALTH, INC.
Entity Type:Organization
Organization Name:CENTRAL MINNESOTA GROUP HEALTH, INC.
Other - Org Name:HEALTHPARTNERS SLEEP HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-203-2020
Mailing Address - Street 1:1245 15TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1802
Mailing Address - Country:US
Mailing Address - Phone:320-253-5220
Mailing Address - Fax:320-203-2075
Practice Address - Street 1:622 ROOSEVELT RD
Practice Address - Street 2:DISTRICT SQUARE SUITE 140
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4867
Practice Address - Country:US
Practice Address - Phone:320-203-2380
Practice Address - Fax:320-203-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty