Organization
REM HENNEPIN INC
Active
Other names
REM Hennepin Inc William
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
5100 WILLIAM AVENUE, EDINA, MN 55436
(952) 922-6776
(952) 922-6885
Mailing address
6600 FRANCE AVE S, EDINA, MN 55435-1805
(952) 922-6776
(952) 922-6885
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
10120432RS
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
610063500
—
MN
Enumeration date
10/25/2006
Last updated
03/04/2023
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