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Organization

ALLIANCE WELLNESS CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. YUSSUF SHAFIE MSW LGSW (EXECUTIVE DIRECTOR)
(952) 992-9803
Entity
Organization

Contact information

Practice address
1120 E 80TH ST STE 108, BLOOMINGTON, MN 55420-1463
(952) 992-9803
Mailing address
1120 E 80TH ST STE 108, BLOOMINGTON, MN 55420-1463
(952) 992-9803

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1077449
MN

Other

Enumeration date
03/12/2015
Last updated
03/12/2015
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