Organization
VALHALLA PLACE BRAINERD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY HIGHAM (CEO)
(214) 365-6112
Entity
Organization
Contact information
Practice address
2215 S 6TH ST, BRAINERD, MN 56401-5549
(763) 276-4856
Mailing address
2215 S 6TH ST, BRAINERD, MN 56401-5549
(763) 276-4856
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
MN
Other
Enumeration date
07/29/2011
Last updated
12/27/2024
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