Wraparound House Calls, Llc | |
4945 1st Ave S Minneapolis MN 55419-5605 | |
(612) 202-8317 | |
Not Available |
Full Name | Wraparound House Calls, Llc |
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Speciality | Clinic/Center |
Location | 4945 1st Ave S, Minneapolis, Minnesota |
Authorized Official Name and Position | Abigail Holley Houts (OWNER) |
Authorized Official Contact | 6122028317 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wraparound House Calls, Llc 3109 W 50th St # 317 Minneapolis MN 55410-2102 Ph: () - | Wraparound House Calls, Llc 4945 1st Ave S Minneapolis MN 55419-5605 Ph: (612) 202-8317 |
NPI Number | 1396248225 |
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Provider Enumeration Date | 03/16/2018 |
Last Update Date | 03/16/2018 |
Medicare PECOS PAC ID | 9931445087 |
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Medicare Enrollment ID | O20190109003256 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396248225 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 1996 (Minnesota) | Primary |
Provider Name | Abigail Porter Hestness Houts |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1700947173 PECOS PAC ID: 5799827184 Enrollment ID: I20100614000910 |
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