Provider First Line Business Practice Location Address:
521 BROADWAY AVENUE NORTH
Provider Second Line Business Practice Location Address:
FIVE COUNTY MENTAL HEALTH CENTER BRAHAM
Provider Business Practice Location Address City Name:
BRAHAM
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-396-3333
Provider Business Practice Location Address Fax Number:
320-396-3363
Provider Enumeration Date:
02/09/2007