| Wise Minds By Rhea Pllc | |
|
1255 S Pokegama Ave Unit 11 Grand Rapids MN 55744-4208 | |
| (218) 999-0018 | |
| (218) 999-9627 |
| Full Name | Wise Minds By Rhea Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1255 S Pokegama Ave Unit 11, Grand Rapids, Minnesota |
| Authorized Official Name and Position | Rhea Lou Del Rosario (CEO, PMHNP) |
| Authorized Official Contact | 2189990018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Minds By Rhea Pllc 1255 S Pokegama Ave Unit 11 Grand Rapids MN 55744-4208 Ph: (218) 999-0018 | Wise Minds By Rhea Pllc 1255 S Pokegama Ave Unit 11 Grand Rapids MN 55744-4208 Ph: (218) 999-0018 |
| NPI Number | 1407620453 |
|---|---|
| Provider Enumeration Date | 11/09/2023 |
| Last Update Date | 02/02/2024 |
| Certification Date | 02/02/2024 |
| Medicare PECOS PAC ID | 8921459009 |
|---|---|
| Medicare Enrollment ID | O20240112003480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407620453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Rhea Del Rosario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336789916 PECOS PAC ID: 5193153385 Enrollment ID: I20200323001181 |
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