Organization
PRIME GROWTH BEHAVIOR SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDIL A GULED (EXECUTIVE DIRECTOR)
(612) 353-4133
Entity
Organization
Contact information
Practice address
3401 HIAWATHA AVE, MINNEAPOLIS, MN 55406-2525
(612) 353-4133
(612) 886-2080
Mailing address
3401 HIAWATHA AVE, MINNEAPOLIS, MN 55406-2525
(612) 353-4133
(612) 886-2080
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/21/2022
Last updated
05/12/2023
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