| Sanford Health Behavioral Health Headwater Act | |
|
722 15th St Nw Bemidji MN 56601-2528 | |
| (218) 751-3289 | |
| (218) 751-3298 |
| Full Name | Sanford Health Behavioral Health Headwater Act |
|---|---|
| Speciality | Clinic/Center |
| Location | 722 15th St Nw, Bemidji, Minnesota |
| Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Contact | 6053288380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Health Behavioral Health Headwater Act Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | Sanford Health Behavioral Health Headwater Act 722 15th St Nw Bemidji MN 56601-2528 Ph: (218) 751-3289 |
| NPI Number | 1427567601 |
|---|---|
| Provider Enumeration Date | 09/20/2017 |
| Last Update Date | 12/21/2023 |
| Certification Date | 12/21/2023 |
| Medicare PECOS PAC ID | 5597725168 |
|---|---|
| Medicare Enrollment ID | O20240523001013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427567601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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