| Family Life Mental Health Center | |
|
1930 Coon Rapids Blvd Nw Coon Rapids MN 55433-4708 | |
| (763) 427-7964 | |
| (763) 427-7976 |
| Full Name | Family Life Mental Health Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1930 Coon Rapids Blvd Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Robert Sullivan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7634277964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Life Mental Health Center 1930 Coon Rapids Blvd Nw Coon Rapids MN 55433-4708 Ph: (763) 427-7964 | Family Life Mental Health Center 1930 Coon Rapids Blvd Nw Coon Rapids MN 55433-4708 Ph: (763) 427-7964 |
| NPI Number | 1760489751 |
|---|---|
| Provider Enumeration Date | 07/05/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760489751 | NPI | - | NPPES |
| 62-20356 | Other | MN | UBH |
| 04358FA | Other | MN | BCBS |
| 1023452 | Other | MN | PREFERRED ONE |
| 106982 | Other | MN | BHP U-CARE |
| 3868 | Other | MN | HEALTH PARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8 (Minnesota) | Primary |
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