| Lake Victoria Mental Health Services, Pc | |
|
3405 Chicago Ave Minneapolis MN 55407-2107 | |
| (651) 724-0497 | |
| Not Available |
| Full Name | Lake Victoria Mental Health Services, Pc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3405 Chicago Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Zachary Olson (OWNER, DIRECTOR, PSYCHOTHERAPIST) |
| Authorized Official Contact | 6517240497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Victoria Mental Health Services, Pc 978 Dayton Ave Saint Paul MN 55104-6544 Ph: () - | Lake Victoria Mental Health Services, Pc 3405 Chicago Ave Minneapolis MN 55407-2107 Ph: (651) 724-0497 |
| NPI Number | 1023377488 |
|---|---|
| Provider Enumeration Date | 05/04/2012 |
| Last Update Date | 04/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023377488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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