| Professional Resource Network, Inc | |
|
2740 American Blvd W Suite 100 Bloomington MN 55431-1203 | |
| (952) 858-8827 | |
| (952) 858-8835 |
| Full Name | Professional Resource Network, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2740 American Blvd W, Bloomington, Minnesota |
| Authorized Official Name and Position | Charie L Devolites (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9528588827 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Resource Network, Inc 2740 American Blvd W Suite 100 Bloomington MN 55431-1203 Ph: (952) 858-8827 | Professional Resource Network, Inc 2740 American Blvd W Suite 100 Bloomington MN 55431-1203 Ph: (952) 858-8827 |
| NPI Number | 1346598547 |
|---|---|
| Provider Enumeration Date | 08/17/2012 |
| Last Update Date | 08/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346598547 | NPI | - | NPPES |
| 1710045430 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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