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Organization
COMMUNITY CARE CLINICS OF MINNESOTA
Active
Organization
COMMUNITY CARE CLINICS OF MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LARBI-ODAM (CHIEF EXECUTIVE OFFICER)
(952) 228-0420
Entity
Organization
Contact information
Practice address
2015 CHICAGO AVE, MINNEAPOLIS, MN 55404-2813
(952) 228-0420
(612) 345-4191
Mailing address
2015 CHICAGO AVE, MINNEAPOLIS, MN 55404-2813
(952) 228-0420
(612) 345-4191
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2018
Last updated
07/06/2023
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