Organization
BRAIN INJURY ASSOCIATION OF MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DONALDSON (CHIEF OPERATIONS OFFICER)
(612) 378-2742
Entity
Organization
Contact information
Practice address
2277 HIGHWAY 36 W STE 200, ROSEVILLE, MN 55113-3830
(612) 378-2742
(612) 378-2789
Mailing address
2277 HIGHWAY 36 W STE 200, ROSEVILLE, MN 55113-3830
(612) 378-2742
(612) 378-2789
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
532442400
MHCP NUMBER
MN
Enumeration date
03/20/2007
Last updated
09/17/2018
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