| Protea Health Llc | |
|
720 8th Ave N Saint Cloud MN 56303-3420 | |
| (320) 420-4469 | |
| Not Available |
| Full Name | Protea Health Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 720 8th Ave N, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Fardowsa Hassan Iman (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3204204469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Protea Health Llc 720 8th Ave N Saint Cloud MN 56303-3420 Ph: (320) 420-4469 | Protea Health Llc 720 8th Ave N Saint Cloud MN 56303-3420 Ph: (320) 420-4469 |
| NPI Number | 1508613795 |
|---|---|
| Provider Enumeration Date | 05/04/2024 |
| Last Update Date | 05/04/2024 |
| Certification Date | 05/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508613795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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