Legacy Mental Health Center

LBN: Mary Mullenbach, Phd, Lp, Inc
Legacy Mental Health Center is an health care organization with primary practice located at 6550 York Ave. S. Suite 503, Edina MN 55435. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as the primary health care specialty. Mary Mullenbach, Phd, Lp, Inc can be contacted via phone (612) 801-3316, or through Mullenbach, Mary via phone (612) 801-3316.

Contact Information

Primary practice address
6550 York Ave. S. Suite 503 Edina MN 55435
Phone: (612) 801-3316
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mullenbach, Mary PH.D., L.P.
Phone: (612) 801-3316

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 4360 Minnesota

Profile Details

NPI number 1801182837
LBN Legal business name Mary Mullenbach, Phd, Lp, Inc
DBA Doing business as Legacy Mental Health Center
Authorized official Mullenbach, Mary PH.D., L.P.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 28th, 2011
Last updated Aug 23rd, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801182837 NPPES
Minnesota MEDICAID 1801192937

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