| Wraparound House Calls, Llc | |
|
4945 1st Ave S Minneapolis MN 55419-5605 | |
| (612) 202-8317 | |
| Not Available |
| Full Name | Wraparound House Calls, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4945 1st Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Abigail Holley Houts (OWNER) |
| Authorized Official Contact | 6122028317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wraparound House Calls, Llc 3109 W 50th St # 317 Minneapolis MN 55410-2102 Ph: () - | Wraparound House Calls, Llc 4945 1st Ave S Minneapolis MN 55419-5605 Ph: (612) 202-8317 |
| NPI Number | 1396248225 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 03/16/2018 |
| Medicare PECOS PAC ID | 9931445087 |
|---|---|
| Medicare Enrollment ID | O20190109003256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396248225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1996 (Minnesota) | Primary |
| Provider Name | Abigail Porter Hestness Houts |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1700947173 PECOS PAC ID: 5799827184 Enrollment ID: I20100614000910 |
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