| Blue Iris Center For Therapeutic Services | |
|
6607 18th Ave S Suite 201 Richfield MN 55423-2784 | |
| (612) 455-4040 | |
| (612) 455-4041 |
| Full Name | Blue Iris Center For Therapeutic Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6607 18th Ave S, Richfield, Minnesota |
| Authorized Official Name and Position | Grant D Chikazawanelson (OWNER THERAPIST) |
| Authorized Official Contact | 6124554040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Iris Center For Therapeutic Services 6607 18th Ave S Suite 201 Richfield MN 55423-2784 Ph: (612) 455-4040 | Blue Iris Center For Therapeutic Services 6607 18th Ave S Suite 201 Richfield MN 55423-2784 Ph: (612) 455-4040 |
| NPI Number | 1285841072 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285841072 | NPI | - | NPPES |
| 69B21CH | Other | MN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0943 (Minnesota) | Primary |
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