Organization
COLEMAN INVESTMENT
Active
Parent organization
9781267
Other names
Coleman Investment
Organization subpart
Yes
Provider details
NPI number
Legal business name
9781267
Authorized official
ALBERT COLEMAN SR. 05-29-1959 (ADMIN)
(612) 968-6205
Entity
Organization
Contact information
Practice address
4001 WILLOW RD N, BROOKLYN PARK, MN 55443-1239
(612) 968-6205
Mailing address
4001 WILLOW RD N, BROOKLYN PARK, MN 55443-1239
(612) 968-6205
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9781267
TIN
MN
Enumeration date
01/29/2009
Last updated
01/29/2009
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