| Meritcare 1219 | |
|
1219 S Washington Ave Detroit Lakes MN 56501-3905 | |
| (218) 846-2000 | |
| Not Available |
| Full Name | Meritcare 1219 |
|---|---|
| Speciality | Psychologist - Family |
| Location | 1219 S Washington Ave, Detroit Lakes, Minnesota |
| Authorized Official Name and Position | Lisa M Carlson (CFO) |
| Authorized Official Contact | 701233344811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Meritcare 1219 1219 S Washington Ave Detroit Lakes MN 56501-3905 Ph: (218) 846-2000 | Meritcare 1219 1219 S Washington Ave Detroit Lakes MN 56501-3905 Ph: (218) 846-2000 |
| NPI Number | 1871749036 |
|---|---|
| Provider Enumeration Date | 08/07/2008 |
| Last Update Date | 08/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871749036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TF0000X | Psychologist - Family | (* (Not Available)) | Primary |
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