| |
451 Lexington Pkwy N Suite 300 Saint Paul MN 55104-4636 | |
(612) 672-1900 | |
(612) 273-1919 |
Full Name | |
---|---|
Speciality | Clinic/center |
Location | 451 Lexington Pkwy N, Saint Paul, Minnesota |
Authorized Official Name and Position | Daniel M. Fromm (SVP / CFO) |
Authorized Official Contact | 6126724976 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 9372 Minneapolis MN 55440-9372 Ph: (612) 672-5390 | 451 Lexington Pkwy N Suite 300 Saint Paul MN 55104-4636 Ph: (612) 672-1900 |
NPI Number | 1497025910 |
---|---|
Provider Enumeration Date | 01/02/2012 |
Last Update Date | 04/07/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497025910 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | 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 |