| Ignite Child Developmental Services P.a. | |
|
2448 18th Ave S Minneapolis MN 55404-4006 | |
| (651) 271-7929 | |
| Not Available |
| Full Name | Ignite Child Developmental Services P.a. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2448 18th Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Andy Paulson (CEO) |
| Authorized Official Contact | 6512717929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ignite Child Developmental Services P.a. 43 Cunningham Rd North Oaks MN 55127-4300 Ph: () - | Ignite Child Developmental Services P.a. 2448 18th Ave S Minneapolis MN 55404-4006 Ph: (651) 271-7929 |
| NPI Number | 1326679978 |
|---|---|
| Provider Enumeration Date | 02/03/2020 |
| Last Update Date | 02/03/2020 |
| Certification Date | 02/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326679978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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