| Yourtime Psychiatry And Medical Cannabis Llc | |
|
6341 Ithaca Ln N Maple Grove MN 55311-4147 | |
| (612) 458-3374 | |
| Not Available |
| Full Name | Yourtime Psychiatry And Medical Cannabis Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6341 Ithaca Ln N, Maple Grove, Minnesota |
| Authorized Official Name and Position | John Harrison (OWNER) |
| Authorized Official Contact | 6124583374 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yourtime Psychiatry And Medical Cannabis Llc 6341 Ithaca Ln N Maple Grove MN 55311-4147 Ph: () - | Yourtime Psychiatry And Medical Cannabis Llc 6341 Ithaca Ln N Maple Grove MN 55311-4147 Ph: (612) 458-3374 |
| NPI Number | 1164112090 |
|---|---|
| Provider Enumeration Date | 05/12/2023 |
| Last Update Date | 05/12/2023 |
| Medicare PECOS PAC ID | 4082077201 |
|---|---|
| Medicare Enrollment ID | O20230905003315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164112090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | John Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205418340 PECOS PAC ID: 2163885385 Enrollment ID: I20230905003410 |
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