| Grey Matter, Llc | |
|
613 Nw 1st Ave Unit 104b Grand Rapids MN 55744-2767 | |
| (612) 702-2167 | |
| Not Available |
| Full Name | Grey Matter, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 613 Nw 1st Ave Unit 104b, Grand Rapids, Minnesota |
| Authorized Official Name and Position | Mandi L Shimek (OWNER) |
| Authorized Official Contact | 6127022167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grey Matter, Llc 613 Nw 1st Ave Unit 104b Grand Rapids MN 55744-2767 Ph: (612) 702-2167 | Grey Matter, Llc 613 Nw 1st Ave Unit 104b Grand Rapids MN 55744-2767 Ph: (612) 702-2167 |
| NPI Number | 1942044524 |
|---|---|
| Provider Enumeration Date | 06/19/2024 |
| Last Update Date | 06/19/2024 |
| Certification Date | 06/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942044524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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