Organization
NIVON WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE M BILLINGSLEY LADC (OWNER/TREATMENT DIRECTOR)
(612) 564-8073
Entity
Organization
Contact information
Practice address
7501 80TH ST S STE 108 & 200, COTTAGE GROVE, MN 55016-4121
(612) 564-8073
Mailing address
7501 80TH ST S STE 108, COTTAGE GROVE, MN 55016-4121
(612) 564-8073
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
MN
Other
Enumeration date
04/20/2018
Last updated
09/30/2019
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