Organization
PREMIERE MENTAL HEALTH LLC
Active
Organization
PREMIERE MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRINCESS KOU GEHYIGON-WALLACE (OWNER)
(763) 913-8125
Entity
Organization
Contact information
Practice address
360 SHERMAN ST STE 290, SAINT PAUL, MN 55102-2564
(763) 913-8125
Mailing address
360 SHERMAN ST STE 290, SAINT PAUL, MN 55102-2564
(763) 913-8125
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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