DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: TUBMAN

MEDICARE: TUBMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center800488-3-CDTMN
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)800487-2-MCHMN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
39026CHOTHERMNBCBS

General Provider Information

NPI Number : 1295866911
Entity Type Code : Organization
Provider Name (Legal Business Name) : TUBMAN
Provider Business Mailing Address
First Line : 4432 CHICAGO AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-3519
Country : US
Telephone Number : 612-870-2444
Fax Number : 612-870-2428
Provider Business Practice Location Address
First Line : 4432 CHICAGO AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-3519
Country : US
Telephone Number : 612-870-2444
Fax Number : 612-870-2428
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : BEVERLY DUSSO
Credential :
Telephone Number : 612-767-6690
Provider Enumeration Date : 03/07/2007
Last Update Date : 11/12/2008

Similar Medicare Providers

1336248053 — MS. NINA A. HOLIDAY-LYNCH LP
Practice Location Address:
4432 CHICAGO AVE
MINNEAPOLIS, MN
55407-3519
Practice Phone: 612-871-0118
Practice Fax: 612-870-2403
1467539726 — SUSAN MARY WINSLOW MSW
Practice Location Address:
4432 CHICAGO AVE
MINNEAPOLIS, MN
55407-3519
Practice Phone: 612-870-2441
Practice Fax: 612-870-2403
1831264977 — DR. THERESA J BERNARD PSYD, LP
Practice Location Address:
4432 CHICAGO AVE
MINNEAPOLIS, MN
55407-3519
Practice Phone: 612-870-2453
Practice Fax:
1578629051 — DEBRA ORBUCH GRAYSON
Practice Location Address:
4432 CHICAGO AVE
MINNEAPOLIS, MN
55407-3519
Practice Phone: 612-870-2441
Practice Fax:
1902956691 — PATRICIA JEAN BRENNEMAN MA, LP
Practice Location Address:
4432 CHICAGO AVE
MINNEAPOLIS, MN
55407-3519
Practice Phone: 612-870-2457
Practice Fax:
1861523557 — MS. LEEANN - SPANGLER LADC
Practice Location Address:
4432 CHICAGO AVE
MINNEAPOLIS, MN
55407-3519
Practice Phone: 612-871-0118
Practice Fax:

Directions to “TUBMAN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.