| Avante Enterprises, Llc. | |
|
4306 Bryant Ave S Minneapolis MN 55409-1709 | |
| (651) 492-5544 | |
| (612) 259-7592 |
| Full Name | Avante Enterprises, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4306 Bryant Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Alejandro Maldonado Rodriguez (PRESIDENT/PSYCHOTHERAPIST) |
| Authorized Official Contact | 6514925544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avante Enterprises, Llc. 4732 17th Ave S Minneapolis MN 55407-3614 Ph: (651) 492-5544 | Avante Enterprises, Llc. 4306 Bryant Ave S Minneapolis MN 55409-1709 Ph: (651) 492-5544 |
| NPI Number | 1538987656 |
|---|---|
| Provider Enumeration Date | 09/27/2024 |
| Last Update Date | 09/27/2024 |
| Certification Date | 09/27/2024 |
| Medicare PECOS PAC ID | 9739617358 |
|---|---|
| Medicare Enrollment ID | O20250110000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538987656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Alejandro Maldonado Rodriguez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1124716006 PECOS PAC ID: 0648708263 Enrollment ID: I20250110000820 |
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