Organization
ANNEX TEEN CLINIC
Active
Organization
ANNEX TEEN CLINIC
Active
Other names
North Suburban Youth Health Clinic, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE THOMPSON MURRAY (CLINICAL DIRECTOR)
(763) 235-1980
Entity
Organization
Contact information
Practice address
5810 42ND AVENUE NORTH, ROBBINSDALE, MN 55422
(763) 533-1316
(763) 531-0315
Mailing address
5810 42ND AVENUE NORTH, ROBBINSDALE, MN 55422
(763) 533-1316
(763) 531-0315
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178182100
—
MN
Enumeration date
03/08/2007
Last updated
02/13/2012
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