Organization Name: | NATIVE AMERICAN COMMUNITY CLINIC |
NPI Number: | 1932258845 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYDIA B CAROS (CEO) |
Mailing Address: | 1213 E Franklin Ave Minneapolis |
State: | MN US |
Postal Code: | 554042923 |
Phone Number: | 6128728086 |
Fax Number: | 6128728547 |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 09/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |