| Neighborhood Healthsource | |
|
10081 Dogwood St. Nw Suite 100 Coon Rapids MN 55448 | |
| (612) 588-9411 | |
| (763) 783-7944 |
| Full Name | Neighborhood Healthsource |
|---|---|
| Speciality | Clinic/Center |
| Location | 10081 Dogwood St. Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Steven Jay 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 2301 Central Ave Ne Minneapolis MN 55418 Ph: (612) 588-9411 | Neighborhood Healthsource 10081 Dogwood St. Nw Suite 100 Coon Rapids MN 55448 Ph: (612) 588-9411 |
| NPI Number | 1659323459 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 06/29/2023 |
| Medicare PECOS PAC ID | 9133199953 |
|---|---|
| Medicare Enrollment ID | O20211029000970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659323459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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