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Organization
MAKING THE CONNECTION
Active
Organization
MAKING THE CONNECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISE C MERILLAT (BEHAVIOR SPECIALIST)
(952) 997-6242
Entity
Organization
Contact information
Practice address
7270 130TH ST W, APPLE VALLEY, MN 55124-9601
(952) 997-6242
(952) 997-2320
Mailing address
7270 130TH ST W, APPLE VALLEY, MN 55124-9601
(952) 997-6242
(952) 997-2320
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
1018126-3-FCC
MN
Other
Enumeration date
08/24/2010
Last updated
08/24/2010
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