| Anchor Recovery, Llc | |
|
116 Central Ave Buffalo MN 55313-1521 | |
| (763) 250-7357 | |
| (855) 221-4223 |
| Full Name | Anchor Recovery, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 116 Central Ave, Buffalo, Minnesota |
| Authorized Official Name and Position | Thao-ha Phan (PARTNER) |
| Authorized Official Contact | 6127472113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anchor Recovery, Llc 116 Central Ave Buffalo MN 55313-1521 Ph: (762) 250-7357 | Anchor Recovery, Llc 116 Central Ave Buffalo MN 55313-1521 Ph: (763) 250-7357 |
| NPI Number | 1649934993 |
|---|---|
| Provider Enumeration Date | 10/23/2021 |
| Last Update Date | 06/14/2024 |
| Certification Date | 06/14/2024 |
| Medicare PECOS PAC ID | 8820438443 |
|---|---|
| Medicare Enrollment ID | O20240430002868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649934993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Thao-ha Phan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477919025 PECOS PAC ID: 3971905076 Enrollment ID: I20240430003089 |
| Provider Name | Kimberley Wobschall |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003232638 PECOS PAC ID: 3870039472 Enrollment ID: I20240718004672 |
| Provider Name | Brian Michael Riehm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578233292 PECOS PAC ID: 2961937628 Enrollment ID: I20241119001513 |
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