Organization
NORTHEAST HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM L EVERETT MA/QMRP/FAAMR (ADMIN ASSIST/PROGRAM DIR)
(612) 789-8841
Entity
Organization
Contact information
Practice address
1918 19TH AVE NE, MINNEAPOLIS, MN 55418-4728
(612) 789-8841
Mailing address
1918 19TH AVE NE, MINNEAPOLIS, MN 55418-4728
(612) 789-8841
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
801746-3RS
MN
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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