Elite Professional Services, Llc | |
10374 Grand Forest Ln Woodbury MN 55129 | |
(651) 207-3887 | |
Not Available |
Full Name | Elite Professional Services, Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 10374 Grand Forest Ln, Woodbury, Minnesota |
Authorized Official Name and Position | Marnie Tuenge (OWNER) |
Authorized Official Contact | 6512073887 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Elite Professional Services, Llc 7595 Currell Blvd Po Box 25641 Woodbury MN 55125 Ph: (651) 207-3887 | Elite Professional Services, Llc 10374 Grand Forest Ln Woodbury MN 55129 Ph: (651) 207-3887 |
NPI Number | 1386385912 |
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Provider Enumeration Date | 04/06/2022 |
Last Update Date | 04/06/2022 |
Certification Date | 03/23/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386385912 | NPI | - | NPPES |
1801325402 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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