| Twin Cities Behavioral Health, Pc | |
|
7300 Metro Blvd Suite 635 Edina MN 55439-2303 | |
| (952) 831-3662 | |
| (952) 831-3559 |
| Full Name | Twin Cities Behavioral Health, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7300 Metro Blvd, Edina, Minnesota |
| Authorized Official Name and Position | Joseph I Shagalow (OWNER/OFFICER) |
| Authorized Official Contact | 9528313662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Twin Cities Behavioral Health, Pc 7300 Metro Blvd Suite 635 Edina MN 55439-2303 Ph: (952) 831-3662 | Twin Cities Behavioral Health, Pc 7300 Metro Blvd Suite 635 Edina MN 55439-2303 Ph: (952) 831-3662 |
| NPI Number | 1295979664 |
|---|---|
| Provider Enumeration Date | 04/28/2009 |
| Last Update Date | 04/28/2009 |
| Medicare PECOS PAC ID | 6709935711 |
|---|---|
| Medicare Enrollment ID | O20090522000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295979664 | NPI | - | NPPES |
| 1164520284 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LP4413 (Minnesota) | Primary |
| Provider Name | Joseph Shagalow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164520284 PECOS PAC ID: 4183689482 Enrollment ID: I20090522000052 |
| Provider Name | Nechama Layah Shagalow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982372256 PECOS PAC ID: 7911393129 Enrollment ID: I20220414001873 |
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