Organization · NPI-2

On-Belay Of Mn Incorporated

Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children · Plymouth, MN

NPI number1396706008
StatusActive
Last updated in NPPESOct 26, 2011

Details

NPI
1396706008
Entity type
Organization (NPI-2)
Legal business name
On-Belay Of Mn Incorporated
Organization subpart
No
Enumeration date
Mar 31, 2006
Last updated
Oct 26, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children5228577MNYes

Other names

  • Anthony Louis Center (Doing Business As)

Practice location

115 Forestview Lane
Plymouth, MN 55441

Phone 763-542-9212

Mailing address

115 Forestview Lane
Plymouth, MN 55441

Phone 763-542-9212 · Fax 763-542-9248

Authorized official

Marcey Theis
Office Manager
7633676981

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