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NPI Code Detail

MEDICARE: CEDAR RIVERSIDE PEOPLE'S CENTER

MEDICARE: CEDAR RIVERSIDE PEOPLE'S CENTER
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
1261QC1500XCommunity Health Clinic/Center
2261QF0400XFederally Qualified Health Center (FQHC)6075748MN

Other Identifiers

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

General Provider Information

NPI Number : 1548340813
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEDAR RIVERSIDE PEOPLE'S CENTER
Provider Business Mailing Address
First Line : 425 20TH AVENUE SOUTH
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-4400
Country : US
Telephone Number : 612-332-4973
Fax Number : 612-238-3534
Provider Business Practice Location Address
First Line : 425 20TH AVENUE SOUTH
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-4400
Country : US
Telephone Number : 612-332-4973
Fax Number : 612-238-3534
Authorized Official
Title or Position : CEO
Name : ANN CHRISTINE ROGERS
Credential :
Telephone Number : 612-332-4973
Provider Enumeration Date : 10/17/2006
Last Update Date : 08/15/2025

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Directions to “CEDAR RIVERSIDE PEOPLE'S CENTER ” Practice Location

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