Yourtime Psychiatry And Medical Cannabis Llc | |
6341 Ithaca Ln N Maple Grove MN 55311-4147 | |
(612) 458-3374 | |
Not Available |
Full Name | Yourtime Psychiatry And Medical Cannabis Llc |
---|---|
Speciality | Clinic/Center |
Location | 6341 Ithaca Ln N, Maple Grove, Minnesota |
Authorized Official Name and Position | John Harrison (OWNER) |
Authorized Official Contact | 6124583374 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Yourtime Psychiatry And Medical Cannabis Llc 6341 Ithaca Ln N Maple Grove MN 55311-4147 Ph: () - | Yourtime Psychiatry And Medical Cannabis Llc 6341 Ithaca Ln N Maple Grove MN 55311-4147 Ph: (612) 458-3374 |
NPI Number | 1164112090 |
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Provider Enumeration Date | 05/12/2023 |
Last Update Date | 05/12/2023 |
Medicare PECOS PAC ID | 4082077201 |
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Medicare Enrollment ID | O20230905003315 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164112090 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | John Harrison |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205418340 PECOS PAC ID: 2163885385 Enrollment ID: I20230905003410 |
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