Organization
CENTRACARE CLINIC
Active
Organization
CENTRACARE CLINIC
Active
Parent organization
CENTRACARE CLINIC
Other names
CentraCare - Becker Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRACARE CLINIC
Authorized official
MICHAEL A BLAIR (SR VP & CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
12800 ROLLING RIDGE RD, BECKER, MN 55308-8838
(763) 261-7000
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 229-4977
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120173
UCARE
—
01
—
35580
HEALTH PARTNERS
—
01
—
86D71CE
BCBS
—
01
—
98-00379
MEDICA
—
05
—
990228700
—
MN
01
—
NA197
PREF ONE
—
Enumeration date
12/13/2006
Last updated
06/23/2025
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