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Organization

SOBER LIVING CONNECTION

Active
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Organization

SOBER LIVING CONNECTION

Active
Other names
ONE TWELVE
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID MICHEAL KASCMAR (OWNER)
(952) 529-8849
Entity
Organization

Contact information

Practice address
11115 MINNETONKA BLVD, HOPKINS, MN 55305
(952) 529-8849
(952) 426-3266
Mailing address
11115 MINNETONKA BLVD, HOPKINS, MN 55305
(952) 529-8849
(952) 426-3266

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
09/30/2020
Last updated
09/30/2020
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