Lion Youth And Community Services, Llc | |
600 25th Ave S Ste 209 Saint Cloud MN 56301-4866 | |
(320) 420-1272 | |
(320) 240-6814 |
Full Name | Lion Youth And Community Services, Llc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 600 25th Ave S Ste 209, Saint Cloud, Minnesota |
Authorized Official Name and Position | Kenneth Longfellow Hanna (OWNER) |
Authorized Official Contact | 3204201272 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lion Youth And Community Services, Llc 600 25th Ave S Ste 209 Saint Cloud MN 56301-4866 Ph: (320) 420-1272 | Lion Youth And Community Services, Llc 600 25th Ave S Ste 209 Saint Cloud MN 56301-4866 Ph: (320) 420-1272 |
NPI Number | 1902302722 |
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Provider Enumeration Date | 04/02/2018 |
Last Update Date | 04/02/2018 |
Identifier | Type | State | Issuer |
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1902302722 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2571659 (Minnesota) | Primary |
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