Organization
CENTRACARE CLINIC
Active
Organization
CENTRACARE CLINIC
Active
Other names
CentraCare Clinic - Lifestyle Health
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS M FELDHEGE (DIRECTOR OF FINANCE AND TREASURER)
(320) 240-2152
Entity
Organization
Contact information
Practice address
2001 STOCKINGER DRIVE, SUITE 101, ST CLOUD, MN 56303
(320) 251-2700
(320) 656-7009
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
MN
Other
Enumeration date
01/20/2017
Last updated
05/11/2017
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