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NPI Code Detail

MEDICARE: COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC

MEDICARE: COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC
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
1251B00000XCase Management Agency
2251K00000XPublic Health or Welfare Agency
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1952477085
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC
Provider Business Mailing Address
First Line : 797 7TH ST E
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-5014
Country : US
Telephone Number : 651-379-4200
Fax Number : 651-292-0347
Provider Business Practice Location Address
First Line : 797 7TH ST E
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-5014
Country : US
Telephone Number : 651-379-4200
Fax Number : 651-292-0347
Authorized Official
Title or Position : ACCOUNTANT II
Name : AMANDA PLESKOVITCH
Credential :
Telephone Number : 651-379-4200
Provider Enumeration Date : 11/28/2006
Last Update Date : 08/30/2024

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Directions to “COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC ” Practice Location

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