| Abintra, Inc | |
|
200 W 98th St Suite 107 Bloomington MN 55420-3820 | |
| (612) 968-6097 | |
| (612) 435-9842 |
| Full Name | Abintra, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 200 W 98th St, Bloomington, Minnesota |
| Authorized Official Name and Position | John Obrien (PRESIDENT) |
| Authorized Official Contact | 6129686097 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abintra, Inc Po Box 113 Crystal Bay MN 55323-0113 Ph: (612) 968-6097 | Abintra, Inc 200 W 98th St Suite 107 Bloomington MN 55420-3820 Ph: (612) 968-6097 |
| NPI Number | 1518412907 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 08/16/2016 |
| Medicare PECOS PAC ID | 0345589859 |
|---|---|
| Medicare Enrollment ID | O20190228000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518412907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 14313 (Minnesota) | Primary |
| Provider Name | Viviane Marie Zastrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568756302 PECOS PAC ID: 4981825924 Enrollment ID: I20141016001534 |
| Provider Name | John O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457579427 PECOS PAC ID: 6800176587 Enrollment ID: I20190304001147 |
| Provider Name | Stephanie K Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457834699 PECOS PAC ID: 2668713439 Enrollment ID: I20190403002402 |
| Provider Name | Elizabeth M Senne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982134342 PECOS PAC ID: 4082049507 Enrollment ID: I20200110000707 |
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