| Mai Hero Beyond Boundaries Llc | |
|
10141 Quince St Nw Coon Rapids MN 55433-5146 | |
| (651) 717-5096 | |
| (612) 484-4569 |
| Full Name | Mai Hero Beyond Boundaries Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 10141 Quince St Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Fue Vang (AUTHORIZED AGENT) |
| Authorized Official Contact | 6517175096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mai Hero Beyond Boundaries Llc 10141 Quince St Nw Coon Rapids MN 55433-5146 Ph: (651) 717-5096 | Mai Hero Beyond Boundaries Llc 10141 Quince St Nw Coon Rapids MN 55433-5146 Ph: (651) 717-5096 |
| NPI Number | 1457150146 |
|---|---|
| Provider Enumeration Date | 03/13/2025 |
| Last Update Date | 03/13/2025 |
| Certification Date | 03/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457150146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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