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Organization

NATIVE AMERICAN COMMUNITY CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LYDIA BETH CAROS DO (EXECUTIVE DIRECTOR)
(612) 872-8086
Entity
Organization

Contact information

Practice address
1213 E FRANKLIN AVE, SUITE 201A, MINNEAPOLIS, MN 55404-2923
(612) 872-8086
(612) 872-8547
Mailing address
1213 E FRANKLIN AVE, SUITE 201A, MINNEAPOLIS, MN 55404-2923
(612) 872-8086
(612) 872-8547

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
MN

Other

Enumeration date
06/17/2009
Last updated
06/17/2009
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