Providence Psychiatry Services, Ltd. | |
708 Division St Deer River MN 56636-8706 | |
(218) 398-1998 | |
Not Available |
Full Name | Providence Psychiatry Services, Ltd. |
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Speciality | Clinic/Center |
Location | 708 Division St, Deer River, Minnesota |
Authorized Official Name and Position | Jean M Vaneps (PSYCHIATRIC NURSE PRACTITIONER) |
Authorized Official Contact | 2183981998 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Providence Psychiatry Services, Ltd. 12860 Mud Lake Rd Ne Box 631 Deer River MN 56636-2174 Ph: (218) 398-1998 | Providence Psychiatry Services, Ltd. 708 Division St Deer River MN 56636-8706 Ph: (218) 398-1998 |
NPI Number | 1871942953 |
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Provider Enumeration Date | 06/08/2016 |
Last Update Date | 06/27/2016 |
Medicare PECOS PAC ID | 4284919200 |
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Medicare Enrollment ID | O20170314000348 |
Identifier | Type | State | Issuer |
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1871942953 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | CNP2221 (Minnesota) | Primary |
Provider Name | Jean M Vaneps |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942642681 PECOS PAC ID: 4587806013 Enrollment ID: I20170417000239 |
Inner Balance Mental Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 39513 Krantz Dr, Deer River, MN 56636 Phone: 507-340-7649 |