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Organization

NATIVE AMERICAN COMMUNITY CLINIC

Active
Parent organization
NATIVE AMERICAN COMMUNITY CLINIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
NATIVE AMERICAN COMMUNITY CLINIC
Authorized official
DR. LYDIA BETH CAROS D.O (CEO)
(612) 872-8086
Entity
Organization

Contact information

Practice address
1213 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2923
(612) 872-8086
(612) 872-8547
Mailing address
1213 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2923
(612) 872-8086
(612) 872-8547

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
596112000
MN
Enumeration date
01/23/2008
Last updated
09/15/2015
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