| Family Link Social Services | |
|
2642 University Ave W Ste 215 Saint Paul MN 55114-1032 | |
| (651) 214-4032 | |
| Not Available |
| Full Name | Family Link Social Services |
|---|---|
| Speciality | Counselor |
| Location | 2642 University Ave W Ste 215, Saint Paul, Minnesota |
| Authorized Official Name and Position | Emmanuel Dimeji Tanimojo (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 6512144032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Link Social Services 2642 University Ave W Ste 215 Saint Paul MN 55114-1032 Ph: (651) 214-4032 | Family Link Social Services 2642 University Ave W Ste 215 Saint Paul MN 55114-1032 Ph: (651) 214-4032 |
| NPI Number | 1578150652 |
|---|---|
| Provider Enumeration Date | 12/23/2020 |
| Last Update Date | 12/23/2020 |
| Certification Date | 12/23/2020 |
| Medicare PECOS PAC ID | 3779987789 |
|---|---|
| Medicare Enrollment ID | O20210812000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578150652 | NPI | - | NPPES |
| P746118131117 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Emmanuel Dimeji Tanimojo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700332764 PECOS PAC ID: 2567791155 Enrollment ID: I20190906001716 |
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