Organization
THE LAZARUS PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BECKY EDEBURN (BOARD MEMBER)
(763) 519-1197
Entity
Organization
Contact information
Practice address
1200 FORD RD, SUITE 2, MINNETONKA, MN 55305-1616
(763) 519-1197
(763) 519-1198
Mailing address
1200 FORD RD, SUITE 2, MINNETONKA, MN 55305-1616
(763) 519-1197
(763) 519-1198
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246L9HO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
11/30/2007
Last updated
11/30/2007
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