Organization
AVALON PROGRAMS, LLC
Active
Other names
Avalon - Midway
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL LINDEMAN (DIRECTOR-REVENUE CYCLE MGMT)
(612) 326-7566
Entity
Organization
Contact information
Practice address
1885 UNIVERSITY AVENUE WEST, SUITE 151, SAINT PAUL, MN 55104
(651) 647-0095
(651) 647-9147
Mailing address
550 MAIN ST, STE 230, NEW BRIGHTON, MN 55112
(612) 326-7600
(651) 631-3231
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1004393
MN
324500000X
Substance Abuse Rehabilitation Facility
1047590.1.CDT
MN
Other
Enumeration date
03/15/2007
Last updated
09/15/2008
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