EAST METRO TRAUMA AND RECOVERY LLC (NPI# 1740880764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740880764 |
Entity Type | Organization |
Organization Name | EAST METRO TRAUMA AND RECOVERY LLC |
Practice Address |
4116 Hoffman Rd White Bear Lake MN 55110-3708 |
Mailing Address |
8154 Enclave Rd Woodbury MN 55125-3032 |
Practice Telephone | 6125904440 |
Practice Fax Number | 6514945915 |
Mailing Telephone | 6125904440 |
Mailing Fax Number | 6514945915 |
Enumeration Date | 2020-10-28 |
Last Update Date | 2020-10-28 |
Authorized Official Name | PAMELA LYNN GRABER (OWNER/CEO) |
Authorized Official Telephone | 6125904440 |
Authorized Official Credential | LMFT |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | BOARD OF MARRIAGE AND FAMILY THERAPY [LICENSING BOARD] | 2672 | 01 |
Street Address |
4116 HOFFMAN RD |
City | WHITE BEAR LAKE |
State | MN |
Zip Code | 55110-3708 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
Find all providers in zip 55110 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063050615 | Metanoia Therapy, Pllc | Clinic/Center | 4525 White Bear Pkwy Ste 119, White Bear Lake, MN 55110-7666 | 2019-12-13 |
1659796050 | Sawyer Solutions LLC | Clinic/Center | 4505 White Bear Pkwy, Suite 2200, White Bear Lake, MN 55110-3678 | 2014-02-22 |
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1245840735 | Kalina Counseling Services | Clinic/Center | 120 7th St Unit 101, Two Harbors, MN 55616-1563 | 2020-08-09 |
1912517392 | Mindful Moments Counseling, LLC | Clinic/Center | 1311 History Ct Nw, New Prague, MN 56071-2457 | 2020-07-31 |
Find all providers with the same taxonomy |
City | WHITE BEAR LAKE |
Zip Code | 55110 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.