| Sils-waivered | |
|
1730 7th Ave S Saint Cloud MN 56301-5711 | |
| (320) 240-3337 | |
| (320) 240-3358 |
| Full Name | Sils-waivered |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1730 7th Ave S, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Joanne Broschofsky (FINANCE DIRECTOR) |
| Authorized Official Contact | 3206501571 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sils-waivered Po Box 2390 Saint Cloud MN 56302-2390 Ph: (320) 650-1550 | Sils-waivered 1730 7th Ave S Saint Cloud MN 56301-5711 Ph: (320) 240-3337 |
| NPI Number | 1942327432 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942327432 | NPI | - | NPPES |
| 936315700 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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