| Family Services Center | |
|
2001 Van Dyke St Maplewood MN 55109-3711 | |
| (651) 290-6818 | |
| (651) 290-6818 |
| Full Name | Family Services Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2001 Van Dyke St, Maplewood, Minnesota |
| Authorized Official Name and Position | Mavis Carol Brehm (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6516027536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Services Center 153 Cesar Chavez St Saint Paul MN 55107-2226 Ph: (651) 222-1816 | Family Services Center 2001 Van Dyke St Maplewood MN 55109-3711 Ph: (651) 290-6818 |
| NPI Number | 1730203944 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 06/18/2008 |
| Medicare PECOS PAC ID | 2062306434 |
|---|---|
| Medicare Enrollment ID | O20061117000440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730203944 | NPI | - | NPPES |
| 310055100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Minnesota) | Primary |
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