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EMPOWERED RECOVERY SOLUTIONS 'LIFE AFTER' RECOVERY RESIDENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON TABAKA SW (OWNER/PROGRAM DIRECTOR)
(763) 732-2065
Entity
Organization

Contact information

Practice address
12714 FREMONT AVE, ZIMMERMAN, MN 55398-9406
(763) 732-2065
Mailing address
6314 CEDAR RD, OAK PARK, MN 56357-8529
(763) 732-2065
(763) 732-2065

Taxonomy

Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary

Other

Enumeration date
08/11/2026
Last updated
08/11/2026
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