| Northeast Youth & Family Services | |
|
1280 N Birch Lake Blvd White Bear Lake MN 55110-6708 | |
| (651) 429-8544 | |
| (651) 407-5301 |
| Full Name | Northeast Youth & Family Services |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1280 N Birch Lake Blvd, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Lisa M Paquet (CLINIC OPERATIONS MANAGER) |
| Authorized Official Contact | 6513793443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Youth & Family Services 3490 Lexington Ave N Ste 205 Shoreview MN 55126-8044 Ph: (651) 486-3808 | Northeast Youth & Family Services 1280 N Birch Lake Blvd White Bear Lake MN 55110-6708 Ph: (651) 429-8544 |
| NPI Number | 1073098810 |
|---|---|
| Provider Enumeration Date | 09/27/2018 |
| Last Update Date | 09/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073098810 | NPI | - | NPPES |
| A880726400 | Other | MN | UPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Secondary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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