| Generations Community Support Service | |
|
60 E Marie St #117 W St Paul MN 55118 | |
| (612) 676-1604 | |
| (651) 552-9874 |
| Full Name | Generations Community Support Service |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 60 E Marie St, W St Paul, Minnesota |
| Authorized Official Name and Position | Kathleen Joan Gorman (PRESIDENT) |
| Authorized Official Contact | 6126761604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Generations Community Support Service 2649 Park Ave Minneapolis MN 55407 Ph: (612) 676-1604 | Generations Community Support Service 60 E Marie St #117 W St Paul MN 55118 Ph: (612) 676-1604 |
| NPI Number | 1861440919 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861440919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |