Organization
ALLIANCE WELLNESS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA JOANN FRIEDMAN LADC (TREATMENT DIRECTOR)
(952) 693-0080
Entity
Organization
Contact information
Practice address
8040 OLD CEDAR AVE. S. STE. 100, BLOOMINGTON, MN 55425-1211
(952) 693-0080
(952) 955-6567
Mailing address
8040 OLD CEDAR AVE. S. STE. 100, BLOOMINGTON, MN 55425-1211
(952) 693-0080
(952) 955-6567
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780186130
NPI
MN
Enumeration date
03/01/2018
Last updated
04/21/2020
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