| Arubah | |
|
3300 County Road 10 Ste 204b Brooklyn Center MN 55429-3072 | |
| (763) 447-5573 | |
| (763) 273-8892 |
| Full Name | Arubah |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3300 County Road 10, Brooklyn Center, Minnesota |
| Authorized Official Name and Position | Anissa Nicole Keyes (PRESIDENT) |
| Authorized Official Contact | 7634475573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arubah 3300 County Road 10 Ste 204b Brooklyn Center MN 55429-3072 Ph: (763) 447-5573 | Arubah 3300 County Road 10 Ste 204b Brooklyn Center MN 55429-3072 Ph: (763) 447-5573 |
| NPI Number | 1962757617 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 09/24/2013 |
| Medicare PECOS PAC ID | 3971923681 |
|---|---|
| Medicare Enrollment ID | O20201019003268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962757617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 2538 (Minnesota) | Secondary |
| 251S00000X | Community/behavioral Health | 2538 (Minnesota) | Primary |
| Provider Name | Jennifer L Jendro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578668166 PECOS PAC ID: 3678575800 Enrollment ID: I20070201000059 |
| Provider Name | Anissa Nicole Keyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154686590 PECOS PAC ID: 4880014596 Enrollment ID: I20201019003288 |
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