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178 9th St E Suite 300 Saint Paul MN 55101-2317 | |
(877) 440-1001 | |
(651) 265-1800 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 178 9th St E, Saint Paul, Minnesota |
Authorized Official Name and Position | Kevin J Pallatao (VP) |
Authorized Official Contact | 9528835348 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8170 33rd Ave S Mail Stop 21110r Minneapolis MN 55425-4516 Ph: (952) 883-7469 | 178 9th St E Suite 300 Saint Paul MN 55101-2317 Ph: (877) 440-1001 |
NPI Number | 1972919512 |
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Provider Enumeration Date | 07/03/2014 |
Last Update Date | 07/03/2014 |
Identifier | Type | State | Issuer |
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1972919512 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (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 |