Organization
CONSILON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE VANG THAO (OWNER)
(651) 356-5216
Entity
Organization
Contact information
Practice address
8744 67TH STREET CT S, COTTAGE GROVE, MN 55016-1600
(651) 356-5216
(651) 797-3061
Mailing address
8744 67TH STREET CT S, COTTAGE GROVE, MN 55016-1600
(651) 356-5216
(651) 797-3061
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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