MERITCARE 1219


Address: 1219 S Washington Ave, Detroit Lakes, MN 56501-3905
Phone: 2188462000

MERITCARE 1219 (NPI# 1871749036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871749036
Entity Type Organization
Organization Name MERITCARE 1219
Practice Address 1219 S Washington Ave
Detroit Lakes
MN 56501-3905
Practice Telephone 2188462000
Mailing Telephone 2188462000
Enumeration Date 2008-08-07
Last Update Date 2008-08-13
Authorized Official Name LISA M CARLSON (CFO)
Authorized Official Telephone 701233344811
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TF0000X Psychologist
Specialization: Family
Behavioral Health & Social Service Providers

Office Location

Street Address 1219 S WASHINGTON AVE
City DETROIT LAKES
State MN
Zip Code 56501-3905

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Taxonomy Information

Taxonomy Code 103TF0000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Family

Taxonomy Definition

Definition to come...

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1184197634 Tracee C Robinson Foote-adams Psychologist 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431-1432 2019-01-08
1093221129 Terri E Bly Psychologist 1150 Montreal Ave Ste 107, Saint Paul, MN 55116-2393 2017-12-27
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1427299023 Susan De Vries Psychologist 570 Asbury St, Suite 310, Saint Paul, MN 55104-1849 2009-03-12
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1730360207 Lisa Marie Johnson Psychologist 2550 University Ave W, Suite 310n, Saint Paul, MN 55114-1052 2007-11-26
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Competitor

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City DETROIT LAKES
Zip Code 56501

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Dataset Information

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.

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