| Neighborhood Healthsource | |
|
342 13th Ave Ne Minneapolis MN 55413-1265 | |
| (612) 588-9411 | |
| (612) 362-4115 |
| Full Name | Neighborhood Healthsource |
|---|---|
| Speciality | Clinic/Center |
| Location | 342 13th Ave Ne, Minneapolis, Minnesota |
| Authorized Official Name and Position | Steve J Knutson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6122872428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighborhood Healthsource 342 13th Ave Ne Minneapolis MN 55413-1265 Ph: (612) 588-9411 | Neighborhood Healthsource 342 13th Ave Ne Minneapolis MN 55413-1265 Ph: (612) 588-9411 |
| NPI Number | 1093753782 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 06/29/2023 |
| Certification Date | 06/29/2023 |
| Medicare PECOS PAC ID | 9133199953 |
|---|---|
| Medicare Enrollment ID | O20080218000627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093753782 | NPI | - | NPPES |
| 591315200 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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