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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