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1601 Highway 13 E Ste 209 Burnsville MN 55337-6848 | |
| (612) 382-8651 | |
| (952) 487-1234 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1601 Highway 13 E Ste 209, Burnsville, Minnesota |
| Authorized Official Name and Position | Carrie Klemz Wolfson (CEO) |
| Authorized Official Contact | 6123828651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1601 Highway 13 E Ste 209 Burnsville MN 55337-6848 Ph: (612) 382-8651 | 1601 Highway 13 E Ste 209 Burnsville MN 55337-6848 Ph: (612) 382-8651 |
| NPI Number | 1609121318 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 07/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609121318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1473 (Minnesota) | Primary |
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