Organization
ALBERTA WINIFRED DESOUZA
Active
Other names
Earthen Vessel Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCIS DE-SOUZA (ADMINISTRATOR)
(952) 486-1249
Entity
Organization
Contact information
Practice address
6220 W 132ND ST, SAVAGE, MN 55378-2484
(952) 215-9206
Mailing address
6220 W 132ND ST, SAVAGE, MN 55378-2484
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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