Organization
E.L.E.V.A.T.E
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAMUNO IMBU JR. (MANAGER)
(612) 272-6659
Entity
Organization
Contact information
Practice address
616 E 25TH ST, MINNEAPOLIS, MN 55404-3704
(612) 353-5065
Mailing address
3835 WASHBURN AVE N, MINNEAPOLIS, MN 55412-1822
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/09/2019
Last updated
06/11/2019
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