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MEMORY CARE CLINIC NPI 1205940863


NPI Information

NPI: 1205940863
Provider Name: MEMORY CARE CLINIC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
2835 W SAINT GERMAIN ST
SAINT CLOUD, MN
ZIP 56301
Phone: (320) 257-1777
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MEMORY CARE CLINIC is a clinic center in Saint Cloud, MN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MEMORY CARE CLINIC NPI is 1205940863. The provider is registered as an organization entity type.

The provider's business location address is:

2835 W SAINT GERMAIN ST
SAINT CLOUD, MN
ZIP 56301-280
Phone: (320) 257-1777
Fax: (320) 257-1776

The provider's authorized official is Sandra L. Wenner .
The authorized official title is Executive Director and has the following contact phone number (320) 257-1777.

The enumeration date for this NPI number is 8/19/2006 and was last updated on 10/19/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center1200898-2MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CO4052OTHERMINNESOTAMEDICARE PROVIDER GROUP NUMBER
2567188400MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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