| Granite City Act | |
|
1017 Connecticut Ave S Sartell MN 56377-2413 | |
| (320) 420-1356 | |
| Not Available |
| Full Name | Granite City Act |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1017 Connecticut Ave S, Sartell, Minnesota |
| Authorized Official Name and Position | Ashley Lynn Anderson (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 3204201356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granite City Act 6645 County Road 4 Ne Kandiyohi MN 56251-9752 Ph: (320) 420-1356 | Granite City Act 1017 Connecticut Ave S Sartell MN 56377-2413 Ph: (320) 420-1356 |
| NPI Number | 1912713157 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912713157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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