MEDICARE: MISSION MENTAL HEALTH LLC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1336761261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSION MENTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	1973 SLOAN PL STE 50B
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55117-2084
Country	:	US
Telephone Number	:	651-214-4605
Fax Number	:

Provider Business Practice Location Address
First Line	:	1973 SLOAN PL STE 50B
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55117-2084
Country	:	US
Telephone Number	:	651-214-4605
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. TEHUT TEFERA
Credential	:
Telephone Number	:	651-214-4605

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	05/14/2020

Similar Medicare Providers

1225076656 — ROY EA HOPE M.D.
Practice Location Address:

1973 SLOAN PL , #225
MAPLEWOOD, MN
55117-2084

Practice Phone: 651-224-1347
Practice Fax: 651-855-0126

1952340242 — MICHAEL D ENGLAND M.D.
Practice Location Address:

1973 SLOAN PL
MAPLEWOOD, MN
55117-2084

Practice Phone: 651-224-1347
Practice Fax: 651-855-0126

1720029630 — BENJAMIN D SUHR M.D.
Practice Location Address:

1973 SLOAN PL , #225
MAPLEWOOD, MN
55117-2084

Practice Phone: 651-224-1347
Practice Fax: 651-776-0932

1851335764 — JOHN B MILLER M.D.
Practice Location Address:

1973 SLOAN PL , #225
MAPLEWOOD, MN
55117-2084

Practice Phone: 651-224-1347
Practice Fax: 651-776-0932

1013442409 — SUPERIOR HEALTH AND HUMAN SERVICES OF MN
Practice Location Address:

1973 SLOAN PL , SUITE 210
MAPLEWOOD, MN
55117-2084

Practice Phone: 651-705-8723
Practice Fax: 651-212-4003

1679351860 — GRAND ETHNIC MINNESOTA HOME CARE LLC
Practice Location Address:

1973 SLOAN PL STE 230
SAINT PAUL, MN
55117-2084

Practice Phone: 651-246-1740
Practice Fax:

Directions to “MISSION MENTAL HEALTH LLC ” 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.