| Acres For Life Therapy & Wellness Center | |
|
12058 55th St N Stillwater MN 55082-2029 | |
| (651) 257-4159 | |
| Not Available |
| Full Name | Acres For Life Therapy & Wellness Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12058 55th St N, Stillwater, Minnesota |
| Authorized Official Name and Position | Lynn Marie Moore (PRESIDENT) |
| Authorized Official Contact | 6512574159 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Acres For Life Therapy & Wellness Center 12058 55th St N Stillwater MN 55082-2029 Ph: (651) 257-4159 | Acres For Life Therapy & Wellness Center 12058 55th St N Stillwater MN 55082-2029 Ph: (651) 257-4159 |
| NPI Number | 1669825857 |
|---|---|
| Provider Enumeration Date | 07/22/2016 |
| Last Update Date | 07/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669825857 | NPI | - | NPPES |
| 8JM77AC | Other | MN | BLUECROSS BLUESHIELD OF MINNESOTA |
| 1053702910 | Other | MN | MINNESOTA HEALTH CARE PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 19404 (Minnesota) | Primary |
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