Emily Program Pc

NPI 1083906994 - Community Based Residential Treatment Facility, Mental Illness - 320800000X

NPI Details
NPI 1083906994
Enumeration Date 05/11/2011
Last Updated 05/11/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name DIRK A DIRK
Position EXECUTIVE DIRECTOR
Phone (651) 645-5323
Fax
Practice Location
2230 COMO AVE
SAINT PAUL MN, 55108-1720, US
Phone (651) 645-5323
Fax
Business Location
2265 COMO AVE
SAINT PAUL MN, 55108-1737, US
Phone (651) 645-5323
Fax
Toxanomy
Taxonomy Code 320800000X
License State
License Number
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According to our database, Emily Program Pc NPI is 1083906994, taxonomy code is 320800000X Emily Program Pc physically located at 2230 Como Ave, Saint Paul MN, 55108-1720. NPI Number 1033115704 has the healthcare provider type.

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1083906994 NPI number is provided on an as is basis without warranty of any kind. 1083906994 is maintained by the National Plan & Provider Enumeration System. The contents of Emily Program Pc are for informational purposes only.