| On The Farm Therapy, Llc | |
|
37272 20th Ave Dennison MN 55018-7425 | |
| (612) 642-1114 | |
| Not Available |
| Full Name | On The Farm Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 37272 20th Ave, Dennison, Minnesota |
| Authorized Official Name and Position | Evonne Broten (OWNER) |
| Authorized Official Contact | 6126421114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| On The Farm Therapy, Llc 37272 20th Ave Dennison MN 55018-7425 Ph: () - | On The Farm Therapy, Llc 37272 20th Ave Dennison MN 55018-7425 Ph: (612) 642-1114 |
| NPI Number | 1770240384 |
|---|---|
| Provider Enumeration Date | 11/18/2021 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770240384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Wildly Rooted Therapy Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 37272 20th Ave, Dennison, MN 55018 Phone: 505-235-2827 |