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Organization

ALLIANCE CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BERYIMAR HAIDIBIT PEROZO-TREJO BS, LADC (CASE MANAGER)
(612) 454-2260
Entity
Organization

Contact information

Practice address
3329 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(612) 454-2260
(612) 454-2340
Mailing address
3329 UNIVERSITY AVENUE SE, MINNEAPOLIS, MN 55414
(612) 454-2260
(612) 454-2340

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
303178
MN

Other

Enumeration date
04/10/2012
Last updated
04/10/2012
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