| Reclaim | |
|
771 Raymond Ave Saint Paul MN 55114-1522 | |
| (612) 235-6743 | |
| Not Available |
| Full Name | Reclaim |
|---|---|
| Speciality | Clinic/Center |
| Location | 771 Raymond Ave, Saint Paul, Minnesota |
| Authorized Official Name and Position | Ryan Fouts (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6122547656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reclaim 771 Raymond Ave Saint Paul MN 55114-1522 Ph: (612) 235-6743 | Reclaim 771 Raymond Ave Saint Paul MN 55114-1522 Ph: (612) 235-6743 |
| NPI Number | 1811129430 |
|---|---|
| Provider Enumeration Date | 08/15/2009 |
| Last Update Date | 12/01/2021 |
| Certification Date | 11/18/2021 |
| Medicare PECOS PAC ID | 7810290228 |
|---|---|
| Medicare Enrollment ID | O20160119001620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811129430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Caitlin G Baldwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508096744 PECOS PAC ID: 8224174156 Enrollment ID: I20091007000479 |
| Provider Name | Dylan Amelia Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518529197 PECOS PAC ID: 9537543863 Enrollment ID: I20220905000180 |
| Provider Name | Amalya Lewin-larin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457013955 PECOS PAC ID: 9638553761 Enrollment ID: I20220908001536 |
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