| Portland Village | |
|
1829 Portland Ave Minneapolis MN 55404-1812 | |
| (612) 872-9045 | |
| (612) 874-1471 |
| Full Name | Portland Village |
|---|---|
| Speciality | Social Worker |
| Location | 1829 Portland Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Dan Cain (PRESIDENT) |
| Authorized Official Contact | 6122871600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Village 1931 W Broadway Ave Minneapolis MN 55411-2400 Ph: (612) 287-1600 | Portland Village 1829 Portland Ave Minneapolis MN 55404-1812 Ph: (612) 872-9045 |
| NPI Number | 1073737185 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073737185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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