Organization
PATHWAY TO FREEDOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY R OLSON LAC (CLINICAL DIRECTOR / OWNER)
(701) 426-6308
Entity
Organization
Contact information
Practice address
418 E ROSSER AVE, SUITE A, BISMARCK, ND 58501-4046
(701) 426-6308
Mailing address
418 E ROSSER AVE, SUITE A, BISMARCK, ND 58501-4046
(701) 426-6308
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1232
ND
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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