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Organization
THE MIDWEST TRAUMA CENTER AND FAMILY RESOURCES
Active
Organization
THE MIDWEST TRAUMA CENTER AND FAMILY RESOURCES
Active
Other names
Midwest Trauma Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORALEE ANN CARTER LICSW (OWNER)
(218) 310-2864
Entity
Organization
Contact information
Practice address
7400 METRO BLVD STE 413, EDINA, MN 55439-2326
(218) 310-2864
Mailing address
7400 METRO BLVD STE 413, EDINA, MN 55439-2326
(218) 310-2864
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15212
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62-64099
UNITED BEHAVIORAL HEALTH
MN
01
—
77B26CA
BLUE CROSS BLUE SHIELD
MN
05
—
858247500
—
MN
Enumeration date
10/17/2007
Last updated
05/06/2008
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