Organization
EVERYDAY LIVING
Active
Organization
EVERYDAY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE ELLIOTT (OWNER)
(612) 695-6041
Entity
Organization
Contact information
Practice address
355 15TH AVE N, SOUTH ST PAUL, MN 55075-1822
(651) 688-7173
Mailing address
355 15TH AVE N, SOUTH ST PAUL, MN 55075-1822
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1050628-3-AFC
MN
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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