Organization
CENTER FOR VICTIMS OF TORTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KA THAO (MEDICAL BILLING COORDINATOR)
(612) 436-4860
Entity
Organization
Contact information
Practice address
649 DAYTON AVE, SAINT PAUL, MN 55104-6631
(612) 436-4800
(612) 436-2604
Mailing address
649 DAYTON AVE, SAINT PAUL, MN 55104-6631
(612) 436-4800
(612) 436-2604
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120700
UCARE
MN
01
—
22572
HEALTHPARTNERS
MN
05
—
243513600
—
MN
01
—
318LOCE
MN BCBS
MN
Enumeration date
08/12/2010
Last updated
07/24/2019
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