Provider Demographics
NPI:1366056806
Name:ASSOCIATES IN MENTAL HEALTH AND ADDICTION SERVICES. P.L.L.C
Entity type:Organization
Organization Name:ASSOCIATES IN MENTAL HEALTH AND ADDICTION SERVICES. P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURIA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:507-452-5206
Mailing Address - Street 1:166 W 3RD ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-6591
Mailing Address - Country:US
Mailing Address - Phone:507-452-5206
Mailing Address - Fax:
Practice Address - Street 1:166 W 3RD ST STE 202
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-6591
Practice Address - Country:US
Practice Address - Phone:507-452-5206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1427401983OtherINDIVIDUAL NPI