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Minneapolis Southwest Mental Health Clinic, Limited

Minneapolis Southwest Mental Health Clinic, Limited is a health care provider in Edina, MN. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 4010 W 65th St Ste 101, Edina, MN 55435-1724, US
Practice Location Phone952-831-4499
Practice Location Fax
Legal Business NameMINNEAPOLIS SOUTHWEST MENTAL HEALTH CLINIC, LIMITED
NPI ?1649485111
Entity TypeOrganization
Enumeration Date ? May 10, 2007
Last Update Date ? Jul 8, 2007
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Minneapolis Southwest Mental Health Clinic, Limited

SpecialtySpecializationLicenseLicense State
Psychologist LP2893Minnesota

legacy-id-icon Legacy Provider IDs of Minneapolis Southwest Mental Health Clinic, Limited

Provider IdIssuer StateIssuer TypeIssuer
11702MIMinnesotaOtherBLUECROSSBLUESHIELD

official-icon Authorized Official of Minneapolis Southwest Mental Health Clinic, Limited

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Minneapolis Southwest Mental Health Clinic, Limited's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Dale Bremner Peterson (MALP)
Authorized Official Title/PositionPRESIDENT
Authorized Official Phone Number952-831-4499