| American Indian Community Development Corp | |
|
1600 East 19th Street Minneapolis MN 55404 | |
| (612) 874-1048 | |
| (612) 813-1612 |
| Full Name | American Indian Community Development Corp |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1600 East 19th Street, Minneapolis, Minnesota |
| Authorized Official Name and Position | Michael P Haag (DIRECTOR) |
| Authorized Official Contact | 6128131610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| American Indian Community Development Corp 1404 E Franklin Ave Minneapolis MN 55404-2134 | American Indian Community Development Corp 1600 East 19th Street Minneapolis MN 55404 Ph: (612) 874-1048 |
| NPI Number | 1194845883 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194845883 | NPI | - | NPPES |
| 200020115141 | Other | MN | ORGANIZATION PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | () | Primary |
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