| Twin Cities Recovery Gym & Wellness Center Llc | |
|
2912 N 2nd St Minneapolis MN 55411-1606 | |
| (612) 720-5599 | |
| Not Available |
| Full Name | Twin Cities Recovery Gym & Wellness Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 2912 N 2nd St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Crystal Rae Hill (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6127205599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Twin Cities Recovery Gym & Wellness Center Llc 15392 60th Ave N Plymouth MN 55446-4541 Ph: (612) 720-5599 | Twin Cities Recovery Gym & Wellness Center Llc 2912 N 2nd St Minneapolis MN 55411-1606 Ph: (612) 720-5599 |
| NPI Number | 1487227161 |
|---|---|
| Provider Enumeration Date | 07/21/2021 |
| Last Update Date | 07/21/2021 |
| Certification Date | 07/21/2021 |
| Medicare PECOS PAC ID | 3476999327 |
|---|---|
| Medicare Enrollment ID | O20240313003168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487227161 | NPI | - | NPPES |
| Provider Name | Jennifer R Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366743916 PECOS PAC ID: 5496930992 Enrollment ID: I20110427000331 |
| Provider Name | James Michael Walch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649358797 PECOS PAC ID: 5193164721 Enrollment ID: I20240416002186 |
| Provider Name | Jacob Thomas Minnig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114660966 PECOS PAC ID: 4284075466 Enrollment ID: I20240520000669 |
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