| Guadalupe Alternative Program(gap) Clinic | |
|
381 Robie St E Saint Paul MN 55107-2415 | |
| (651) 602-7976 | |
| (651) 602-7977 |
| Full Name | Guadalupe Alternative Program(gap) Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 381 Robie St E, Saint Paul, Minnesota |
| Authorized Official Name and Position | Mavis Carol Brehm (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6516027536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Guadalupe Alternative Program(gap) Clinic 153 Cesar Chavez St Saint Paul MN 55107-2226 Ph: (651) 222-1816 | Guadalupe Alternative Program(gap) Clinic 381 Robie St E Saint Paul MN 55107-2415 Ph: (651) 602-7976 |
| NPI Number | 1013100809 |
|---|---|
| Provider Enumeration Date | 08/24/2007 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013100809 | NPI | - | NPPES |
| 863083600 | Medicaid | MN | |
| 103124 | Other | MN | UCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Minnesota) | Primary |
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