Organization
AXIS BEHAVIORAL HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOSTEYA ABDULAHI FARAH (PRESIDENT)
(612) 644-3912
Entity
Organization
Contact information
Practice address
740 12TH AVE S, SAINT CLOUD, MN 56301-4219
(612) 644-3912
Mailing address
740 12TH AVE S, SAINT CLOUD, MN 56301-4219
(612) 644-3912
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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