Organization
TWIN CITIES BEHAVIORAL HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH SHAGALOW LP (OWNER)
(612) 998-5669
Entity
Organization
Contact information
Practice address
2 DIVISION ST E STE 103, BUFFALO, MN 55313-1774
(612) 998-5669
Mailing address
8120 PENN AVE S STE 554, BLOOMINGTON, MN 55431-1333
(612) 998-5669
(952) 831-3559
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1074289
MN
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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