Provider Demographics
NPI:1811794795
Name:ORNATE MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ORNATE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:HEDUIK
Authorized Official - Middle Name:MAH
Authorized Official - Last Name:CHO-MOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN PMHNP-BC
Authorized Official - Phone:651-357-7824
Mailing Address - Street 1:9913 TWIN LAKES PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-3221
Mailing Address - Country:US
Mailing Address - Phone:651-357-7824
Mailing Address - Fax:
Practice Address - Street 1:9913 TWIN LAKES PKWY NW
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-3221
Practice Address - Country:US
Practice Address - Phone:651-357-7824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty