Organization
SAGE PRAIRIE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS BLUE JR. (OPERATIONS OFFICER)
(952) 451-8160
Entity
Organization
Contact information
Practice address
13005 COUNTY ROAD 5, BURNSVILLE, MN 55337
(952) 451-8160
(612) 437-4913
Mailing address
13005 COUNTY ROAD 5, BURNSVILLE, MN 55337-2226
(952) 451-8160
(612) 437-4913
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/02/2014
Last updated
09/25/2018
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