Organization
GENTLE CARING MIND HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIS TABUKUM (OWNER)
(651) 283-1185
Entity
Organization
Contact information
Practice address
3833 COON RAPIDS BLVD NW STE 260, COON RAPIDS, MN 55433-2597
(651) 283-1185
Mailing address
3833 COON RAPIDS BLVD NW STE 260, COON RAPIDS, MN 55433-2597
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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