NPI: 1386682078
Provider Name: NEIGHBORHOOD HEALTHSOURCE
Former Legal Business Name: FREMONT COMMUNITY HEALTH SERVICES, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization
Specialization: Federally Qualified Health Center (FQHC)
CLIA Number: 24D1026553
Address:
3300 FREMONT AVE N
MINNEAPOLIS, MN
ZIP 55412
Phone: (612) 588-9411
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NEIGHBORHOOD HEALTHSOURCE is a federally qualified health center (fqhc) clinic center in Minneapolis, MN. NEIGHBORHOOD HEALTHSOURCE NPI is 1386682078. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Fremont Community Health Services, Inc.
The provider's business location address is:
3300 FREMONT AVE N
MINNEAPOLIS, MN
ZIP 55412-405
Phone: (612) 588-9411
Fax: (612) 522-6627
The provider's authorized official is Steve J Knutson .
The authorized official title is Executive Director and has the following contact phone number (612) 287-2428.
The CLIA number assigned to this NPI record is 24D1026553 - other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/3/2006 and was last updated on 6/29/2023.