| Free Range Mental Health Pllc | |
|
103 3rd St W Northfield MN 55057-2037 | |
| (507) 649-0433 | |
| Not Available |
| Full Name | Free Range Mental Health Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 103 3rd St W, Northfield, Minnesota |
| Authorized Official Name and Position | Daniel Watts (OWNER) |
| Authorized Official Contact | 5076490433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Free Range Mental Health Pllc 103 3rd St W Northfield MN 55057-2037 Ph: () - | Free Range Mental Health Pllc 103 3rd St W Northfield MN 55057-2037 Ph: (507) 649-0433 |
| NPI Number | 1356006811 |
|---|---|
| Provider Enumeration Date | 11/01/2021 |
| Last Update Date | 11/01/2021 |
| Medicare PECOS PAC ID | 6507252517 |
|---|---|
| Medicare Enrollment ID | O20220330002997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356006811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Daniel Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437702289 PECOS PAC ID: 6002145562 Enrollment ID: I20201215001907 |
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