Gould Enterprise, Pllc | |
1995 Burns Ave Ste B Saint Paul MN 55119 | |
(651) 739-5173 | |
(651) 739-8907 |
Full Name | Gould Enterprise, Pllc |
---|---|
Speciality | Clinic/center |
Location | 1995 Burns Ave Ste B, Saint Paul, Minnesota |
Authorized Official Name and Position | Solomon M Gould (OWNER) |
Authorized Official Contact | 6517395173 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gould Enterprise, Pllc 1995 Burns Ave Ste B Saint Paul MN 55119-4906 Ph: (651) 739-5173 | Gould Enterprise, Pllc 1995 Burns Ave Ste B Saint Paul MN 55119 Ph: (651) 739-5173 |
NPI Number | 1750888335 |
---|---|
Provider Enumeration Date | 04/10/2018 |
Last Update Date | 06/26/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750888335 | NPI | - | NPPES |
3415 | Other | MN | MN LICENSE |
1518232149 | Other | MN | TYPE I NPI |
1750888335 | Other | TYPE II NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
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 |