Dominion Healthcare Services L - Medicare Mental Health Clinic in Brooklyn Center, MN

Dominion Healthcare Services L is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Brooklyn Center, Minnesota. The current practice location for Dominion Healthcare Services L is 5421 Penn Ave N, Brooklyn Center, Minnesota. For appointments, you can reach them via phone at (612) 258-8794. The mailing address for Dominion Healthcare Services L is 5421 Penn Ave N, Brooklyn Center, Minnesota and phone number is (612) 258-8794.

Dominion Healthcare Services L is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1073270427. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (612) 258-8794.

Contact Information

Dominion Healthcare Services L
5421 Penn Ave N
Brooklyn Center
MN 55430-2943
(612) 258-8794
Not Available

Mental Health Clinic Profile

Full NameDominion Healthcare Services L
SpecialityClinic/Center
Location5421 Penn Ave N, Brooklyn Center, Minnesota
Authorized Official Name and PositionYaria Bangura (MANAGER)
Authorized Official Contact6122588794
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dominion Healthcare Services L
5421 Penn Ave N
Brooklyn Center
MN 55430-2943

Ph: (612) 258-8794
Dominion Healthcare Services L
5421 Penn Ave N
Brooklyn Center
MN 55430-2943

Ph: (612) 258-8794

NPI Details:

NPI Number1073270427
Provider Enumeration Date11/19/2021
Last Update Date09/01/2023
Certification Date09/01/2023

Medicare PECOS Information:

Medicare PECOS PAC ID6406211572
Medicare Enrollment IDO20230424002460

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Medical Identifiers

Medical identifiers for Dominion Healthcare Services L such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073270427NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Dominion Healthcare Services L acts as a billing entity for following providers:
Provider NameYaria I Bangura
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235680836
PECOS PAC ID: 5698053346
Enrollment ID: I20161031001967

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