Organization
CLUES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIKA MEZA (MENTAL HEALTH PROGRAMS COORDINATOR)
(612) 746-3530
Entity
Organization
Contact information
Practice address
720 E LAKE ST, MINNEAPOLIS, MN 55407-1547
(612) 746-3500
Mailing address
720 E LAKE ST, MINNEAPOLIS, MN 55407-1547
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2837
MN
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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