| Open Door Health Center | |
|
309 Holly Ln Mankato MN 56001-5422 | |
| (507) 388-2120 | |
| (507) 388-3924 |
| Full Name | Open Door Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 309 Holly Ln, Mankato, Minnesota |
| Authorized Official Name and Position | Jennifer L Beckius (CFO) |
| Authorized Official Contact | 5073445507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Door Health Center 309 Holly Ln Mankato MN 56001-5422 Ph: (507) 388-2120 | Open Door Health Center 309 Holly Ln Mankato MN 56001-5422 Ph: (507) 388-2120 |
| NPI Number | 1891740908 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 07/08/2024 |
| Medicare PECOS PAC ID | 7012944085 |
|---|---|
| Medicare Enrollment ID | O20070717000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891740908 | NPI | - | NPPES |
| 201094100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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