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Organization

FOCUSING ON ADVOCATING, MENTORING AND EDUCATING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAKESHA DEADWYLER CPRSR, CPSS (EXECUTIVE DIRECTOR)
(612) 449-9707
Entity
Organization

Contact information

Practice address
3859 FREMONT AVE N, MINNEAPOLIS, MN 55412-2042
(912) 449-9707
Mailing address
8501 VIRGINIA CIR N, SAINT LOUIS PARK, MN 55426-2451
(612) 449-9707

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
09/18/2024
Last updated
09/18/2024
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