Organization · NPI-2

Addiction Care Physicians

Substance Abuse Rehabilitation Facility · Minneapolis, MN

NPI number1962899013
StatusActive
Last updated in NPPESApr 16, 2015

Details

NPI
1962899013
Entity type
Organization (NPI-2)
Legal business name
Addiction Care Physicians
Organization subpart
No
Enumeration date
Apr 16, 2015
Last updated
Apr 16, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
324500000X Substance Abuse Rehabilitation Facility––Yes

Practice location

4001 Stinson Blvd
Suite 212
Minneapolis, MN 55421-3488

Phone 612-788-2273 · Fax 612-886-1939

Mailing address

3616 Roosevelt St Ne
St Anthony Village, MN 55418-1559

Phone 612-788-2273 · Fax 612-886-1939

Authorized official

Sirri Atang Nomo-Ongolo
Administration
6127882273

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