| Zion Medical Treatment Center Llc | |
|
13770 Frontier Ct Burnsville MN 55337-4810 | |
| (651) 808-2866 | |
| Not Available |
| Full Name | Zion Medical Treatment Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13770 Frontier Ct, Burnsville, Minnesota |
| Authorized Official Name and Position | Mariline Corvil (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6127033373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zion Medical Treatment Center Llc 13770 Frontier Ct Ste 100 Burnsville MN 55337-4811 Ph: (651) 808-2866 | Zion Medical Treatment Center Llc 13770 Frontier Ct Burnsville MN 55337-4810 Ph: (651) 808-2866 |
| NPI Number | 1891453890 |
|---|---|
| Provider Enumeration Date | 12/07/2021 |
| Last Update Date | 12/23/2022 |
| Certification Date | 12/23/2022 |
| Medicare PECOS PAC ID | 9537535885 |
|---|---|
| Medicare Enrollment ID | O20221012001136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891453890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Bryan J Schwieters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841243631 PECOS PAC ID: 4183644255 Enrollment ID: I20051205000186 |
| Provider Name | Phoebe Kerubo Nyabando |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174190466 PECOS PAC ID: 5890175095 Enrollment ID: I20220706001619 |
| Provider Name | Ablavi Saboutey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023737806 PECOS PAC ID: 2062869175 Enrollment ID: I20231111000404 |
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