| St. Joseph's Medical Center | |
|
523 N 3rd St 4th Floor Brainerd MN 56401-3054 | |
| (218) 828-7394 | |
| (218) 828-3130 |
| Full Name | St. Joseph's Medical Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 523 N 3rd St, Brainerd, Minnesota |
| Authorized Official Name and Position | Kevin Boren (VP OF FINANCE) |
| Authorized Official Contact | 2187861009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Joseph's Medical Center 523 N 3rd St Brainerd MN 56401-3054 Ph: (218) 828-7394 | St. Joseph's Medical Center 523 N 3rd St 4th Floor Brainerd MN 56401-3054 Ph: (218) 828-7394 |
| NPI Number | 1740393032 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740393032 | NPI | - | NPPES |
| 736045200 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 330736 (Minnesota) | Primary |
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