Organization
RESURGE TREATMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY T. SMITH LADC (OWNER)
(763) 478-1418
Entity
Organization
Contact information
Practice address
2314 PLYMOUTH AVE N, MINNEAPOLIS, MN 55411-3636
(763) 323-0769
Mailing address
11990 JONQUIL ST NW, COON RAPIDS, MN 55433-1797
(763) 323-0769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/06/2018
Last updated
01/04/2019
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