Organization
VALHALLA PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY HIGHAM (CEO)
(214) 365-6112
Entity
Organization
Contact information
Practice address
2807 BROOKDALE DR, BROOKLYN PARK, MN 55444-1844
(651) 925-8200
Mailing address
6043 HUDSON RD, 220, WOODBURY, MN 55125-1018
(651) 925-8200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
15731
MN
261QM2800X
Methadone Clinic
Primary
1063405
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260163778
—
MN
Enumeration date
10/18/2012
Last updated
12/23/2024
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