Healthcare Provider Details
I. General information
NPI: 1609923853
Provider Name (Legal Business Name): ACCORD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/03/2007
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1515 ENERGY PARK DRIVE
ST. PAUL MN
55108
US
IV. Provider business mailing address
1515 ENERGY PARK DRIVE
ST. PAUL MN
55108
US
V. Phone/Fax
- Phone: 612-362-4400
- Fax: 612-362-4479
- Phone: 612-362-4400
- Fax: 612-362-4479
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RITA
WIERSMA
Title or Position: ACCORD CEO
Credential:
Phone: 612-362-4404