Organization
IGNITE CHILD DEVELOPMENTAL SERVICES P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY PAULSON PHD, LP (CEO)
(651) 271-7929
Entity
Organization
Contact information
Practice address
2448 18TH AVE S, MINNEAPOLIS, MN 55404-4006
(651) 271-7929
Mailing address
43 CUNNINGHAM RD, NORTH OAKS, MN 55127-4300
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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