Organization
CENTRACARE CLINIC
Active
Other names
CentraCare - Coordinated Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A BLAIR (SR VP & CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
3701 12TH ST N STE 102, SAINT CLOUD, MN 56303-2253
(320) 656-7195
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2017
Last updated
06/23/2025
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