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1 Water St W Ste 270 Saint Paul MN 55107-2053 | |
(651) 789-0547 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 1 Water St W Ste 270, Saint Paul, Minnesota |
Authorized Official Name and Position | Sara Cooper (OWNER) |
Authorized Official Contact | 6517890547 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1 Water St W Ste 270 Saint Paul MN 55107-2053 Ph: (651) 789-0547 | 1 Water St W Ste 270 Saint Paul MN 55107-2053 Ph: (651) 789-0547 |
NPI Number | 1033624341 |
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Provider Enumeration Date | 12/08/2017 |
Last Update Date | 12/08/2017 |
Identifier | Type | State | Issuer |
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1033624341 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 6368 (Minnesota) | Primary |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |