Optiovillage, Inc

NPI 1184002784 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1184002784
Enumeration Date 05/14/2015
Last Updated 05/14/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name TRENTON JON TRENTON
Position CLINICAL DIRECTOR
Phone (763) 712-1903
Fax (763) 712-1917
Practice Location
630 E MAIN ST
ANOKA MN, 55303-2527, US
Phone (763) 712-1903
Fax (763) 712-1917
Business Location
630 EAST MAIN ST.
ANOKA MN, 55303, US
Phone (763) 712-1903
Fax (763) 712-1917
Toxanomy
Taxonomy Code 251S00000X
License State
License Number
Remove 1184002784 NPI Number
 

According to our database, Optiovillage, Inc NPI is 1184002784, taxonomy code is 251S00000X Optiovillage, Inc physically located at 630 E Main St, Anoka MN, 55303-2527. NPI Number 1033115704 has the healthcare provider type.

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1184002784 NPI number is provided on an as is basis without warranty of any kind. 1184002784 is maintained by the National Plan & Provider Enumeration System. The contents of Optiovillage, Inc are for informational purposes only.