| Gordon Parks Area Learning Center(alc) | |
|
1212 University Ave W Saint Paul MN 55104-4123 | |
| (651) 293-5900 | |
| (651) 602-7517 |
| Full Name | Gordon Parks Area Learning Center(alc) |
|---|---|
| Speciality | Clinic/Center |
| Location | 1212 University Ave W, Saint Paul, Minnesota |
| Authorized Official Name and Position | Reuben Moore (CEO) |
| Authorized Official Contact | 6516027500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Parks Area Learning Center(alc) 153 Cesar Chavez St Saint Paul MN 55107-2226 Ph: (651) 602-7500 | Gordon Parks Area Learning Center(alc) 1212 University Ave W Saint Paul MN 55104-4123 Ph: (651) 293-5900 |
| NPI Number | 1194902072 |
|---|---|
| Provider Enumeration Date | 01/23/2008 |
| Last Update Date | 05/15/2024 |
| Medicare PECOS PAC ID | 2062306434 |
|---|---|
| Medicare Enrollment ID | O20091016000170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194902072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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