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Organization

OPTIONS RESIDENTIAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN P SAMMON LMFT, LADC (PRESIDENT)
(612) 226-7120
Entity
Organization

Contact information

Practice address
2105 W BURNSVILLE PKWY, BURNSVILLE, MN 55337-4237
(952) 564-3030
(952) 564-3038
Mailing address
2105 W BURNSVILLE PKWY, BURNSVILLE, MN 55337-4237
(952) 564-3030
(952) 564-3038

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HE-01084-04
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HE-01084-04
MN DEPARTMENT OF HEALTH
MN
Enumeration date
03/17/2010
Last updated
03/17/2010
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