Organization
METRO TREATMENT OF MINNESOTA, LP
Active
Other names
Lake Superior Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK JOHN CHUNN (CFO)
(407) 351-7080
Entity
Organization
Contact information
Practice address
14 E CENTRAL ENTRANCE, SUITE B, DULUTH, MN 55811-5508
(218) 786-0223
(218) 786-0226
Mailing address
14050 TOWN LOOP BLVD, SUITE 204, ORLANDO, FL 32837-6190
(407) 351-7080
(407) 351-6930
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1008733-1-CDT
MN
3336C0002X
Clinic Pharmacy
261964-8
MN
Other
Enumeration date
05/15/2007
Last updated
11/22/2021
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