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Organization
AWAKEN RECOVERY CENTER L.L.C
Active
Organization
AWAKEN RECOVERY CENTER L.L.C
Active
Parent organization
AWAKEN RECOVERY CENTER L.L.C
Organization subpart
Yes
Provider details
NPI number
Legal business name
AWAKEN RECOVERY CENTER L.L.C
Authorized official
RODERICK EUGENE COLEMAN (EXECUTIVE DIRECTOR)
(763) 331-2162
Entity
Organization
Contact information
Practice address
400 SUITE D 393 NORTH DUNLAP, ST PAUL, MN 55104
(763) 331-2162
Mailing address
400 SUITE D 393 NORTH DUNLAP, ST PAUL, MN 55104
(763) 331-2162
(651) 340-6888
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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