| Youth By Beths Place Llc | |
|
1606 30th Ave S Ste 2 Moorhead MN 56560-5147 | |
| (701) 936-1190 | |
| (218) 600-5488 |
| Full Name | Youth By Beths Place Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1606 30th Ave S Ste 2, Moorhead, Minnesota |
| Authorized Official Name and Position | Cassie Kasowski (LADC) |
| Authorized Official Contact | 7019361190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth By Beths Place Llc 1606 30th Ave S Ste 2 Moorhead MN 56560-5147 Ph: (701) 936-1190 | Youth By Beths Place Llc 1606 30th Ave S Ste 2 Moorhead MN 56560-5147 Ph: (701) 936-1190 |
| NPI Number | 1154042018 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/08/2022 |
| Certification Date | 09/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154042018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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