Organization
NACC MEDICATION ASSISTED RECOVERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM STRONG (ECONOMIC DEVELOPMENT DIRECTOR)
(218) 679-3341
Entity
Organization
Contact information
Practice address
1213 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2923
(612) 872-8086
(612) 872-8547
Mailing address
1213 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2923
(612) 872-8086
(612) 872-8547
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001
TRIBAL LICENSE
—
Enumeration date
01/18/2018
Last updated
01/18/2018
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