Organization
CHILDRENS HEALTH CARE
Active
Other names
Childrens Hospitals and Clinics of Minnesota
Organization subpart
No
Provider details
NPI number
Authorized official
MARC H GORELICK MD (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(612) 813-8031
Entity
Organization
Contact information
Practice address
345 NORTH SMITH AVENUE, CHILDRENS SPECIALTY CLINIC PSYCHOLOGICAL SERVICES STPL, ST PAUL, MN 55102
(651) 220-6720
(651) 220-6707
Mailing address
5901 LINCOLN DRIVE, CBC-2-REV/PE, EDINA, MN 55436-1611
(952) 992-5398
(952) 992-6917
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
331019
MN
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
331019
MN
Other
Enumeration date
10/02/2006
Last updated
10/31/2022
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