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1675 Beam Ave Ste 200 Saint Paul MN 55109-1479 | |
(651) 213-8060 | |
(651) 257-9237 |
Full Name | |
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Speciality | Substance Abuse Rehabilitation Facility |
Location | 1675 Beam Ave Ste 200, Saint Paul, Minnesota |
Authorized Official Name and Position | Maureen Ring (DIRECTOR NETWORK RELATIONS AO) |
Authorized Official Contact | 6126726740 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 147 Minneapolis MN 55440-0147 Ph: (612) 672-6724 | 1675 Beam Ave Ste 200 Saint Paul MN 55109-1479 Ph: (651) 213-8060 |
NPI Number | 1821263856 |
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Provider Enumeration Date | 04/30/2008 |
Last Update Date | 10/04/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821263856 | NPI | - | NPPES |
684137000 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
324500000X | Substance Abuse Rehabilitation Facility | 830715 (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 |