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381 Robie St E Saint Paul MN 55107-2415 | |
(651) 602-7976 | |
(651) 602-7977 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 381 Robie St E, Saint Paul, Minnesota |
Authorized Official Name and Position | Mavis Carol Brehm (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6516027536 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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153 Cesar Chavez St Saint Paul MN 55107-2226 Ph: (651) 222-1816 | 381 Robie St E Saint Paul MN 55107-2415 Ph: (651) 602-7976 |
NPI Number | 1013100809 |
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Provider Enumeration Date | 08/24/2007 |
Last Update Date | 06/18/2008 |
Identifier | Type | State | Issuer |
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1013100809 | NPI | - | NPPES |
863083600 | Medicaid | MN | |
103124 | Other | MN | UCARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (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 |