Organization
COMPLEMENTARY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERI DIMOND (PRESIDENT)
(612) 861-9601
Entity
Organization
Contact information
Practice address
2345 STONE CREEK LN W, CHANHASSEN, MN 55317-7413
(612) 203-5257
(952) 470-5783
Mailing address
6701 PENN AVE S STE 301, RICHFIELD, MN 55423-2085
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/28/2010
Last updated
02/28/2010
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