| Our Healing Ground Pllc | |
|
Po Box 17370 Lot 537 St. Paul MN 55117 | |
| (218) 214-7476 | |
| Not Available |
| Full Name | Our Healing Ground Pllc |
|---|---|
| Speciality | Social Worker |
| Location | Po Box 17370 Lot 537, St. Paul, Minnesota |
| Authorized Official Name and Position | Katrina Gregor (OWNER) |
| Authorized Official Contact | 2182147476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Healing Ground Pllc P.o. Box 17370 Lot 537 St Paul MN 55117-0370 Ph: (218) 214-7476 | Our Healing Ground Pllc Po Box 17370 Lot 537 St. Paul MN 55117 Ph: (218) 214-7476 |
| NPI Number | 1114569258 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 01/13/2020 |
| Medicare PECOS PAC ID | 8426481516 |
|---|---|
| Medicare Enrollment ID | O20191203002579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114569258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Katrina Gregor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306309992 PECOS PAC ID: 2961835053 Enrollment ID: I20191203002703 |
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