| The Roses Llc | |
|
330 3rd St S Virginia MN 55792-2632 | |
| (218) 639-5510 | |
| Not Available |
| Full Name | The Roses Llc |
|---|---|
| Speciality | Counselor |
| Location | 330 3rd St S, Virginia, Minnesota |
| Authorized Official Name and Position | Rebecca M Leaders (OWNER) |
| Authorized Official Contact | 2186395510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Roses Llc 521 16th Ave W Eveleth MN 55734-1171 Ph: (218) 639-5510 | The Roses Llc 330 3rd St S Virginia MN 55792-2632 Ph: (218) 639-5510 |
| NPI Number | 1427832690 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 08/21/2023 |
| Certification Date | 08/21/2023 |
| Medicare PECOS PAC ID | 1557717600 |
|---|---|
| Medicare Enrollment ID | O20231025001820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427832690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Diane Debra Leaders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366196115 PECOS PAC ID: 9830585892 Enrollment ID: I20220331001441 |
| Provider Name | Rebecca M Leaders |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013329937 PECOS PAC ID: 8729434873 Enrollment ID: I20240313001667 |
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