| Beyond Brain Injury | |
|
7587 Kimberly Ln Eden Prairie MN 55346-4259 | |
| (612) 384-1007 | |
| Not Available |
| Full Name | Beyond Brain Injury |
|---|---|
| Speciality | Clinic/Center |
| Location | 7587 Kimberly Ln, Eden Prairie, Minnesota |
| Authorized Official Name and Position | Nicole Lainhart (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6123841007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beyond Brain Injury 7587 Kimberly Ln Eden Prairie MN 55346-4259 Ph: () - | Beyond Brain Injury 7587 Kimberly Ln Eden Prairie MN 55346-4259 Ph: (612) 384-1007 |
| NPI Number | 1174395453 |
|---|---|
| Provider Enumeration Date | 10/30/2023 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/30/2023 |
| Medicare PECOS PAC ID | 4082051826 |
|---|---|
| Medicare Enrollment ID | O20240328001162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174395453 | NPI | - | NPPES |
| Provider Name | Nicole L Lainhart |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1760449276 PECOS PAC ID: 5991142739 Enrollment ID: I20240328001209 |
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