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Organization

TWIN CITIES IMPACT

Active
Other names
Twin Cities IMPACT
Organization subpart
No

Provider details

NPI number
Authorized official
TRILA NAOMIE MALONE OWNER (PRESIDENT)
(651) 329-0733
Entity
Organization

Contact information

Practice address
11208 HANSON BLVD NW UNIT 215, COON RAPIDS, MN 55433-3731
(651) 329-0733
Mailing address
11208 HANSON BLVD NW UNIT 215, COON RAPIDS, MN 55433-3731
(651) 329-0733

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
07/03/2023
Last updated
07/03/2023
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