Organization
EDGE HEALTH CARE AND MENTAL HEALTH SERVICES
Active
Organization
EDGE HEALTH CARE AND MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EKAN EKONG NP (PMHNP-BC)
(763) 498-4448
Entity
Organization
Contact information
Practice address
157 GRASS LAKE PL APT 309, SHOREVIEW, MN 55126-2063
(763) 498-4448
Mailing address
157 GRASS LAKE PL APT 309, SHOREVIEW, MN 55126-2063
(763) 498-4448
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/14/2024
Last updated
10/21/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up