Organization
SHALOM MENTAL HEALTH SERVICES
Active
Other names
SHALOM MENTAL HEALTH SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
AZIE JUDITH KHAN (OWNER/CEO)
(515) 918-3955
Entity
Organization
Contact information
Practice address
3751 RIDGE AVE, ANOKA, MN 55303-1489
(515) 918-3955
Mailing address
7211 208TH CIR N, FOREST LAKE, MN 55025-2903
(515) 918-3955
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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