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Organization
COURAGE CENTER
Active
Organization
COURAGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICE JOHNSON (CFO)
(763) 520-0206
Entity
Organization
Contact information
Practice address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 588-0811
(763) 520-0237
Mailing address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 588-0811
(763) 520-0237
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
8356799
MN
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
8356799
MN
332B00000X
Durable Medical Equipment & Medical Supplies
8356799
MN
Other
Enumeration date
10/27/2005
Last updated
07/13/2007
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