Organization
PRODIGAL HOUSE INC.
Active
Organization
PRODIGAL HOUSE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMELIA MERLINDA GREIN BS, LADC (EXECUTIVE DIRECTOR)
(612) 721-8556
Entity
Organization
Contact information
Practice address
5103 MINNEHAHA AVE BLDG 16, MINNEAPOLIS, MN 55417-1647
(612) 721-3358
(612) 721-2619
Mailing address
5103 MINNEHAHA AVE BLDG 16, MINNEAPOLIS, MN 55417-1647
(612) 721-3358
(612) 721-2619
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
801974
MN
Other
Enumeration date
11/07/2006
Last updated
06/19/2008
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