Provider Demographics
NPI:1962408906
Name:OPEN CITIES HEALTH CENTER, INC. - RICE STREET
Entity type:Organization
Organization Name:OPEN CITIES HEALTH CENTER, INC. - RICE STREET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-290-9245
Mailing Address - Street 1:409 NORTH DUNLAP STREET
Mailing Address - Street 2:
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104
Mailing Address - Country:US
Mailing Address - Phone:651-290-9200
Mailing Address - Fax:651-290-9210
Practice Address - Street 1:916 RICE STREET
Practice Address - Street 2:
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117
Practice Address - Country:US
Practice Address - Phone:651-290-9200
Practice Address - Fax:651-290-9210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPEN CITIES HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-23
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QC1500X
MN052730261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN666253600Medicaid
MN666253600Medicaid