| |
1415 1st St E Park Rapids MN 56470-1803 | |
(218) 237-5464 | |
(218) 237-5541 |
Full Name | |
---|---|
Speciality | Clinic/center - Community Health |
Location | 1415 1st St E, Park Rapids, Minnesota |
Authorized Official Name and Position | Marlee Morrison (COMMUNITY HEALTH DIRECTOR) |
Authorized Official Contact | 2182375474 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
600 Pleasant Ave S Park Rapids MN 56470-1431 Ph: (218) 237-5464 | 1415 1st St E Park Rapids MN 56470-1803 Ph: (218) 237-5464 |
NPI Number | 1457356206 |
---|---|
Provider Enumeration Date | 06/17/2005 |
Last Update Date | 03/04/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457356206 | NPI | - | NPPES |
568515000 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
Enlightenment Psychiatry Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1011 1st St E Ste 5, Park Rapids, MN 56470 Phone: 320-321-9599 Fax: 877-962-3624 | |