Premiere Mental Health Llc | |
360 Sherman St Ste 290 Saint Paul MN 55102-2564 | |
(763) 913-8125 | |
Not Available |
Full Name | Premiere Mental Health Llc |
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Speciality | Clinic/center |
Location | 360 Sherman St Ste 290, Saint Paul, Minnesota |
Authorized Official Name and Position | Princess Kou Gehyigon-wallace (OWNER) |
Authorized Official Contact | 7639138125 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Premiere Mental Health Llc 360 Sherman St Ste 290 Saint Paul MN 55102-2564 Ph: (763) 913-8125 | Premiere Mental Health Llc 360 Sherman St Ste 290 Saint Paul MN 55102-2564 Ph: (763) 913-8125 |
NPI Number | 1023832938 |
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Provider Enumeration Date | 11/08/2024 |
Last Update Date | 11/08/2024 |
Identifier | Type | State | Issuer |
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1023832938 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |