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Organization

IRIDESCENT CARE COLLABORATIVE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL S MERRIAM (SENIOR ADMINISTRATOR)
(952) 484-6897
Entity
Organization

Contact information

Practice address
3754 PLEASANT AVE STE 205, MINNEAPOLIS, MN 55409-1279
(952) 484-6897
Mailing address
3754 PLEASANT AVE STE 205, MINNEAPOLIS, MN 55409-1279
(952) 484-6897

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/23/2025
Last updated
09/23/2025
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