| Indian Health Board Of Minneapolis, Inc | |
|
2101 Minnehaha Avenue South Minneapolis MN 55404-3107 | |
| (612) 721-9800 | |
| (612) 721-7870 |
| Full Name | Indian Health Board Of Minneapolis, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2101 Minnehaha Avenue South, Minneapolis, Minnesota |
| Authorized Official Name and Position | Patrick Rock (CEO) |
| Authorized Official Contact | 6127219800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Health Board Of Minneapolis, Inc 1315 E 24th St Ste 1 Minneapolis MN 55404-3959 Ph: (612) 721-9830 | Indian Health Board Of Minneapolis, Inc 2101 Minnehaha Avenue South Minneapolis MN 55404-3107 Ph: (612) 721-9800 |
| NPI Number | 1760949168 |
|---|---|
| Provider Enumeration Date | 02/22/2019 |
| Last Update Date | 05/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760949168 | NPI | - | NPPES |
| 1811999162 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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