| Metro Behavioral Health, Llc | |
|
2701 University Ave Se Ste 205 Minneapolis MN 55414-3236 | |
| (612) 767-7770 | |
| (612) 767-7772 |
| Full Name | Metro Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2701 University Ave Se Ste 205, Minneapolis, Minnesota |
| Authorized Official Name and Position | Abdulahi A Mohamed (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6124232852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metro Behavioral Health, Llc 2701 University Ave Se Ste 205 Minneapolis MN 55414-3236 Ph: (612) 767-7770 | Metro Behavioral Health, Llc 2701 University Ave Se Ste 205 Minneapolis MN 55414-3236 Ph: (612) 767-7770 |
| NPI Number | 1568778660 |
|---|---|
| Provider Enumeration Date | 08/26/2010 |
| Last Update Date | 09/04/2021 |
| Certification Date | 09/04/2021 |
| Medicare PECOS PAC ID | 7618112913 |
|---|---|
| Medicare Enrollment ID | O20130313000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568778660 | NPI | - | NPPES |
| 1568778660 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jerome L Kroll |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235147729 PECOS PAC ID: 8224172218 Enrollment ID: I20100215000036 |
| Provider Name | Abdulahi A Mohamed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255669156 PECOS PAC ID: 9436394731 Enrollment ID: I20130314000517 |
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