| Twin Cities Providence Care | |
|
2233 Hamline Ave N Ste 510 Roseville MN 55113-5003 | |
| (651) 242-9796 | |
| Not Available |
| Full Name | Twin Cities Providence Care |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2233 Hamline Ave N Ste 510, Roseville, Minnesota |
| Authorized Official Name and Position | Najma Mohamed (PRESIDENT) |
| Authorized Official Contact | 6512429796 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Twin Cities Providence Care 2233 Hamline Ave N Ste 510 Roseville MN 55113-5003 Ph: (651) 242-9796 | Twin Cities Providence Care 2233 Hamline Ave N Ste 510 Roseville MN 55113-5003 Ph: (651) 242-9796 |
| NPI Number | 1801442462 |
|---|---|
| Provider Enumeration Date | 08/09/2019 |
| Last Update Date | 07/13/2022 |
| Certification Date | 07/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801442462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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