Organization
GREENHAVEN THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON COOK (OWNER/THERAPIST)
(763) 203-3164
Entity
Organization
Contact information
Practice address
540 GREENHAVEN RD STE 204, ANOKA, MN 55303-1675
(763) 203-3164
(651) 925-0524
Mailing address
540 GREENHAVEN RD STE 204, ANOKA, MN 55303-1675
(763) 203-3164
(651) 925-0524
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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