| Gildersleeve Counseling Services, Llc | |
|
801 Twelve Oaks Center Dr 803b Wayzata MN 55391-4601 | |
| (952) 303-5487 | |
| Not Available |
| Full Name | Gildersleeve Counseling Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 801 Twelve Oaks Center Dr, Wayzata, Minnesota |
| Authorized Official Name and Position | Lori B Gildersleeve (OWNER) |
| Authorized Official Contact | 6123863365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gildersleeve Counseling Services, Llc 801 Twelve Oaks Center Dr 803b Wayzata MN 55391-4601 Ph: (952) 303-5487 | Gildersleeve Counseling Services, Llc 801 Twelve Oaks Center Dr 803b Wayzata MN 55391-4601 Ph: (952) 303-5487 |
| NPI Number | 1285979047 |
|---|---|
| Provider Enumeration Date | 12/05/2012 |
| Last Update Date | 12/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285979047 | NPI | - | NPPES |
| 934215000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP3779 (Minnesota) | Primary |
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