Organization
HOPE VILLAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSELLA COLLINS-PUOCH LICSW (PRESIDENT)
(612) 669-9202
Entity
Organization
Contact information
Practice address
6043 HUDSON RD, SUITE 372, WOODBURY, MN 55125-1018
(651) 714-9171
(651) 714-9176
Mailing address
6043 HUDSON RD, SUITE 372, WOODBURY, MN 55125-1018
(651) 714-9171
(651) 714-9176
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18674
MN
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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