| Habilitative Services, Llc | |
|
1400 Madison Ave Ste 206 Mankato MN 56001-5477 | |
| (507) 625-6047 | |
| Not Available |
| Full Name | Habilitative Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1400 Madison Ave Ste 206, Mankato, Minnesota |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Habilitative Services, Llc 6600 France Ave S Ste 500 Edina MN 55435-1878 Ph: (952) 563-2207 | Habilitative Services, Llc 1400 Madison Ave Ste 206 Mankato MN 56001-5477 Ph: (507) 625-6047 |
| NPI Number | 1992216766 |
|---|---|
| Provider Enumeration Date | 10/19/2017 |
| Last Update Date | 03/04/2023 |
| Certification Date | 03/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992216766 | NPI | - | NPPES |
| 1070961-1-HCBS | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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