Organization
ERC MINNESOTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA SHEPEL (CREDENTIALING MANAGER)
(425) 214-9321
Entity
Organization
Contact information
Practice address
14551 JUDICIAL RD STE 100, BURNSVILLE, MN 55306-4991
(877) 825-8584
Mailing address
7351 E LOWRY BLVD STE 200, DENVER, CO 80230-6083
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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