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Organization

AWAKEN RECOVERY CENTER L.L.C

Active
Parent organization
AWAKEN RECOVERY CENTER L.L.C
Organization subpart
Yes

Provider details

NPI number
Legal business name
AWAKEN RECOVERY CENTER L.L.C
Authorized official
RODERICK EUGENE COLEMAN (EXECUTIVE DIRECTOR)
(763) 331-2162
Entity
Organization

Contact information

Practice address
400 SUITE D 393 NORTH DUNLAP, ST PAUL, MN 55104
(763) 331-2162
Mailing address
400 SUITE D 393 NORTH DUNLAP, ST PAUL, MN 55104
(763) 331-2162
(651) 340-6888

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
09/21/2018
Last updated
09/21/2018
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