| East Metro Trauma And Recovery Llc | |
|
4116 Hoffman Rd White Bear Lake MN 55110-3708 | |
| (612) 590-4440 | |
| (651) 494-5915 |
| Full Name | East Metro Trauma And Recovery Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4116 Hoffman Rd, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Pamela Lynn Graber (OWNER/CEO) |
| Authorized Official Contact | 6125904440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Metro Trauma And Recovery Llc 8154 Enclave Rd Woodbury MN 55125-3032 Ph: (612) 590-4440 | East Metro Trauma And Recovery Llc 4116 Hoffman Rd White Bear Lake MN 55110-3708 Ph: (612) 590-4440 |
| NPI Number | 1740880764 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 07/21/2022 |
| Certification Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740880764 | NPI | - | NPPES |
| 2672 | Other | MN | BOARD OF MARRIAGE AND FAMILY THERAPY LICENSING BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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