Organization
PRUDENCE PROFESSIONAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKET NNEKA ALLEN-FAHNBULLEH CEO (CEO)
(612) 701-3202
Entity
Organization
Contact information
Practice address
3034 BOONE AVE N, NEW HOPE, MN 55427-2419
(612) 701-3202
Mailing address
3034 BOONE AVE N, NEW HOPE, MN 55427-2419
(612) 701-3202
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
880516800033
MN
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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