| Sengsavang Inc. | |
|
4361 Bear Path Trl Eagan MN 55122-2218 | |
| (612) 234-2397 | |
| Not Available |
| Full Name | Sengsavang Inc. |
|---|---|
| Speciality | Counselor |
| Location | 4361 Bear Path Trl, Eagan, Minnesota |
| Authorized Official Name and Position | Keo Sengsavang (OWNER) |
| Authorized Official Contact | 6122342397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sengsavang Inc. 4361 Bear Path Trl Eagan MN 55122-2218 Ph: (612) 234-2397 | Sengsavang Inc. 4361 Bear Path Trl Eagan MN 55122-2218 Ph: (612) 234-2397 |
| NPI Number | 1306419007 |
|---|---|
| Provider Enumeration Date | 07/20/2021 |
| Last Update Date | 07/20/2021 |
| Certification Date | 07/20/2021 |
| Medicare PECOS PAC ID | 0547600694 |
|---|---|
| Medicare Enrollment ID | O20240506004548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306419007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Keo Sengsavang |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063965721 PECOS PAC ID: 1456791508 Enrollment ID: I20240506004585 |
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