Organization
SKIPPED PARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE GRACE MA, LMFT (CO-OWNER)
(612) 578-2167
Entity
Organization
Contact information
Practice address
357 KELLOGG BLVD E, SAINT PAUL, MN 55101-1411
(612) 578-2167
Mailing address
357 KELLOGG BLVD E, SAINT PAUL, MN 55101-1411
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2916
MN
251S00000X
Community/Behavioral Health Agency
CC00826
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336548387
PROVIDER NPI
MN
01
—
1568876381
PROVIDER NPI
MN
Enumeration date
08/15/2014
Last updated
08/15/2014
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