| Midway Family Services, Llc | |
|
14214 Davenport Path Rosemount MN 55068-4177 | |
| (612) 644-6723 | |
| Not Available |
| Full Name | Midway Family Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14214 Davenport Path, Rosemount, Minnesota |
| Authorized Official Name and Position | Driss Moukrim (PRESIDENT/CEO) |
| Authorized Official Contact | 6122424132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midway Family Services, Llc 14214 Davenport Path Rosemount MN 55068 Ph: () - | Midway Family Services, Llc 14214 Davenport Path Rosemount MN 55068-4177 Ph: (612) 644-6723 |
| NPI Number | 1366972861 |
|---|---|
| Provider Enumeration Date | 06/16/2017 |
| Last Update Date | 06/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366972861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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