| Bush Evening Treatment | |
|
451 Lexington Pkwy N Saint Paul MN 55104-4636 | |
| (651) 280-2000 | |
| (651) 280-3995 |
| Full Name | Bush Evening Treatment |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 451 Lexington Pkwy N, Saint Paul, Minnesota |
| Authorized Official Name and Position | Morris Goodwin (CHIEF ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 6512802000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bush Evening Treatment 451 Lexington Pkwy N Saint Paul MN 55104-4636 Ph: (651) 280-2000 | Bush Evening Treatment 451 Lexington Pkwy N Saint Paul MN 55104-4636 Ph: (651) 280-2000 |
| NPI Number | 1538312939 |
|---|---|
| Provider Enumeration Date | 10/29/2008 |
| Last Update Date | 10/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538312939 | NPI | - | NPPES |
| 555055600 | Other | MN | MEDICAL ASSISTANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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