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NPI Code Detail

MEDICARE: ALLEGRA JOY GARCIA CHW

MEDICARE: ALLEGRA JOY GARCIA CHW
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1508680505
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLEGRA JOY GARCIA CHW
Provider Business Mailing Address
First Line : PO BOX 566
Second Line :
City : RED LAKE
State : MN
Zip : 56671-0566
Country : US
Telephone Number : 218-679-1320
Fax Number :
Provider Business Practice Location Address
First Line : 2115 CEDAR AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-3102
Country : US
Telephone Number : 612-518-0799
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2024
Last Update Date : 11/14/2024

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Directions to “ ALLEGRA JOY GARCIA CHW” Practice Location

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