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600 Pleasant Ave S Park Rapids MN 56470-1431 | |
(218) 616-3700 | |
(218) 616-3737 |
Full Name | |
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Speciality | Clinic/center |
Location | 600 Pleasant Ave S, Park Rapids, Minnesota |
Authorized Official Name and Position | Ben Koppelman (CEO/PRESIDENT) |
Authorized Official Contact | 2186163500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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600 Pleasant Ave S Park Rapids MN 56470-1431 Ph: (218) 616-3700 | 600 Pleasant Ave S Park Rapids MN 56470-1431 Ph: (218) 616-3700 |
NPI Number | 1013460864 |
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Provider Enumeration Date | 07/28/2016 |
Last Update Date | 08/15/2024 |
Identifier | Type | State | Issuer |
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1013460864 | NPI | - | NPPES |
CE9455 | Other | MN | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (Minnesota) | 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 | |