Organization
ADDICTION CARE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIRRI ATANG NOMO-ONGOLO MD (ADMINISTRATION)
(612) 788-2273
Entity
Organization
Contact information
Practice address
4001 STINSON BLVD, SUITE 212, MINNEAPOLIS, MN 55421-3488
(612) 788-2273
(612) 886-1939
Mailing address
3616 ROOSEVELT ST NE, ST ANTHONY VILLAGE, MN 55418-1559
(612) 788-2273
(612) 886-1939
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
000000000
—
Enumeration date
04/16/2015
Last updated
04/16/2015
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