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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