# IRIDESCENT CARE COLLABORATIVE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528930906
- **Authorized official:** MICHAEL S MERRIAM (SENIOR ADMINISTRATOR)
- **Authorized official phone:** (952) 484-6897

## Contact information

- **Practice address:** 3754 PLEASANT AVE STE 205, MINNEAPOLIS, MN 55409-1279
- **Practice address phone:** (952) 484-6897
- **Mailing address:** 3754 PLEASANT AVE STE 205, MINNEAPOLIS, MN 55409-1279
- **Mailing address phone:** (952) 484-6897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 09/23/2025
- **Last updated:** 09/23/2025