| Odhc School Base - Lcs | |
|
110 Fulton St # 204 Mankato MN 56001-2520 | |
| (507) 388-2120 | |
| Not Available |
| Full Name | Odhc School Base - Lcs |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 110 Fulton St # 204, Mankato, Minnesota |
| Authorized Official Name and Position | Jennifer Beckius (CFO/CO-CEO) |
| Authorized Official Contact | 5073445507 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Odhc School Base - Lcs 309 Holly Ln Mankato MN 56001-5422 Ph: (507) 388-2120 | Odhc School Base - Lcs 110 Fulton St # 204 Mankato MN 56001-2520 Ph: (507) 388-2120 |
| NPI Number | 1770417404 |
|---|---|
| Provider Enumeration Date | 06/09/2026 |
| Last Update Date | 08/11/2026 |
| Certification Date | 08/11/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770417404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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