| Evernorth Clinic, Pllc | |
|
8040 Padre Way Ne Otsego MN 55330-4551 | |
| (931) 436-8197 | |
| Not Available |
| Full Name | Evernorth Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 8040 Padre Way Ne, Otsego, Minnesota |
| Authorized Official Name and Position | Amanda Johnson (OWNER, FOUNDER) |
| Authorized Official Contact | 9314368197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evernorth Clinic, Pllc 400 S 4th St Ste 410 Minneapolis MN 55415-1419 Ph: () - | Evernorth Clinic, Pllc 8040 Padre Way Ne Otsego MN 55330-4551 Ph: (931) 436-8197 |
| NPI Number | 1053116483 |
|---|---|
| Provider Enumeration Date | 02/18/2025 |
| Last Update Date | 02/18/2025 |
| Certification Date | 02/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053116483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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