Organization
CLARION4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE CHRISTIANSEN (OWNER)
(612) 998-4948
Entity
Organization
Contact information
Practice address
504 E 73RD ST, #1, RICHFIELD, MN 55423-3273
(612) 998-4948
Mailing address
504 E 73RD ST, #1, RICHFIELD, MN 55423-3273
(612) 998-4948
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
01/09/2014
Last updated
01/09/2014
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