Organization
SUNRISE PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIANA GREENE (PRESIDENT)
(612) 328-4819
Entity
Organization
Contact information
Practice address
4721 HIAWATHA AVE, MINNEAPOLIS, MN 55406-3928
(612) 822-1720
Mailing address
4721 HIAWATHA AVE, MINNEAPOLIS, MN 55406-3928
(612) 822-1720
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1074667
MN
324500000X
Substance Abuse Rehabilitation Facility
1074667
MN
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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