| Ted Lobby, Llc | |
|
6600 France Ave S # 472 Edina MN 55435-1805 | |
| (952) 922-0192 | |
| Not Available |
| Full Name | Ted Lobby, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6600 France Ave S, Edina, Minnesota |
| Authorized Official Name and Position | Theodore Edward Lobby (PRESIDENT) |
| Authorized Official Contact | 9529220192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ted Lobby, Llc 6600 France Ave S # 472 Edina MN 55435-1805 Ph: (952) 922-0192 | Ted Lobby, Llc 6600 France Ave S # 472 Edina MN 55435-1805 Ph: (952) 922-0192 |
| NPI Number | 1750301040 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750301040 | NPI | - | NPPES |
| 045757400 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1145 (Minnesota) | Primary |
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