Provider Demographics
NPI:1568001063
Name:ACCRA CARE
Entity Type:Organization
Organization Name:ACCRA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-935-3515
Mailing Address - Street 1:12600 WHITEWATER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9450
Mailing Address - Country:US
Mailing Address - Phone:952-935-3515
Mailing Address - Fax:
Practice Address - Street 1:12600 WHITEWATER DR STE 100
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9450
Practice Address - Country:US
Practice Address - Phone:952-935-3515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty