| Crestpoint Wellness, Llc | |
|
758 Grand Ave Ste 200 Saint Paul MN 55105-3382 | |
| (612) 800-9000 | |
| Not Available |
| Full Name | Crestpoint Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 758 Grand Ave Ste 200, Saint Paul, Minnesota |
| Authorized Official Name and Position | Damir Stevan Utrzan (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 6129007021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestpoint Wellness, Llc 1295 Northland Dr Mendota Heights MN 55120-1371 Ph: (612) 900-7021 | Crestpoint Wellness, Llc 758 Grand Ave Ste 200 Saint Paul MN 55105-3382 Ph: (612) 800-9000 |
| NPI Number | 1952143745 |
|---|---|
| Provider Enumeration Date | 06/11/2024 |
| Last Update Date | 09/09/2024 |
| Certification Date | 09/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952143745 | NPI | - | NPPES |
| 1123432 | Other | MN | DEPARTMENT OF HUMAN SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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