Organization · NPI-2

Alliance Clinic, LLC

Health Maintenance Organization · Minneapolis, MN

NPI number1558495010
StatusActive
Last updated in NPPESDec 26, 2024

Details

NPI
1558495010
Entity type
Organization (NPI-2)
Legal business name
Alliance Clinic, LLC
Organization subpart
Yes
Enumeration date
Mar 15, 2007
Certification date
Dec 26, 2024
Last updated
Dec 26, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
302R00000X Health Maintenance Organization1009916MNYes
324500000X Substance Abuse Rehabilitation Facility1009916-2-CDTMN

Other names

  • Valhalla Minneapolis (Doing Business As)

Practice location

3329 University Ave Se
Minneapolis, MN 55414-3325

Phone 612-638-2260 · Fax 612-638-2340

Mailing address

550 Main St
#230
New Brighton, MN 55112

Phone 612-326-7600 · Fax 612-326-7549

Authorized official

Jay Higham
Ceo
2143656112

Is something wrong?

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