Organization
BEHAVIORIAL CHANGE COUNSLING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMED A WARSAME MHRM (CHIEF EXECUTIVE OFFICER)
(612) 423-5695
Entity
Organization
Contact information
Practice address
3015 CEDAR AVE S, MINNEAPOLIS, MN 55407-1805
(612) 423-5695
(612) 208-0661
Mailing address
3015 CEDAR AVE S, MINNEAPOLIS, MN 55407-1805
(612) 423-5695
(612) 208-0661
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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