| Center For Human Development Of White Bear Lake, Inc. | |
|
4505 White Bear Pkwy Suite 1800 White Bear Lake MN 55110-3678 | |
| (651) 426-8191 | |
| (651) 426-6766 |
| Full Name | Center For Human Development Of White Bear Lake, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 4505 White Bear Pkwy, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Nancy L Soete (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 6514268191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Human Development Of White Bear Lake, Inc. 4505 White Bear Pkwy Suite 1800 White Bear Lake MN 55110-3678 Ph: (651) 426-8191 | Center For Human Development Of White Bear Lake, Inc. 4505 White Bear Pkwy Suite 1800 White Bear Lake MN 55110-3678 Ph: (651) 426-8191 |
| NPI Number | 1639250111 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639250111 | NPI | - | NPPES |
| 103074 | Other | MN | UCARE |
| 790082100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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