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Organization

PROFESSIONAL COUNSELING CENTER

Active
Parent organization
NORTHERN INTEGRATED HEALTH INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHERN INTEGRATED HEALTH INC
Authorized official
MRS. SARAH GRILL (OFFICE MANAGER)
(952) 548-9340
Entity
Organization

Contact information

Practice address
12450 WAYZATA BLVD STE 202, MINNETONKA, MN 55305-1927
(952) 548-9340
(952) 548-9350
Mailing address
12450 WAYZATA BLVD STE 202, MINNETONKA, MN 55305-1927
(952) 548-9340
(952) 548-9350

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
12/01/2011
Last updated
12/01/2011
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