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Organization

FAMILY FOCUSED RECOVERY SERVICES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DERRYCK VANCURK MOORE LADC (CEO)
(612) 220-8645
Entity
Organization

Contact information

Practice address
4080 W BROADWAY AVE, ROBBINSDALE, MN 55422-5604
(612) 220-8645
Mailing address
4080 W BROADWAY AVE, ROBBINSDALE, MN 55422-5604
(612) 220-8645

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
301674
MN

Other

Enumeration date
03/14/2012
Last updated
03/14/2012
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