Organization
SUPPORTIVE LIVING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M OLLENDICK WRIGHT LICSW (EXECUTIVE DIRECTOR)
(763) 277-1038
Entity
Organization
Contact information
Practice address
5615 BROOKLYN BLVD STE 200, BROOKLYN CENTER, MN 55429-3086
(763) 537-6612
Mailing address
5615 BROOKLYN BLVD STE 200, BROOKLYN CENTER, MN 55429-3086
(763) 537-6612
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MN
Other
Enumeration date
03/15/2007
Last updated
05/24/2013
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