| Independent Management Services Of Mn, Inc. | |
|
101 21st St Se Ste 1 Austin MN 55912-4322 | |
| (507) 437-6389 | |
| (507) 437-0977 |
| Full Name | Independent Management Services Of Mn, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 101 21st St Se Ste 1, Austin, Minnesota |
| Authorized Official Name and Position | Stephen W. Thorson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5074376389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent Management Services Of Mn, Inc. 101 21st St Se Ste 1 Austin MN 55912-4322 Ph: (507) 437-6389 | Independent Management Services Of Mn, Inc. 101 21st St Se Ste 1 Austin MN 55912-4322 Ph: (507) 437-6389 |
| NPI Number | 1255472957 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 02/13/2012 |
| Medicare PECOS PAC ID | 1658674775 |
|---|---|
| Medicare Enrollment ID | O20160125000954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255472957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mark M Sherman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073532651 PECOS PAC ID: 1759555675 Enrollment ID: I20111110000637 |
| Provider Name | Ryan Thomas Thorson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225326705 PECOS PAC ID: 0042451635 Enrollment ID: I20160201000322 |
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