The Storefront Group

NPI 1033293972 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1033293972
Enumeration Date 10/25/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name PATRICK PATRICK
Position CEO
Phone (612) 861-1675
Fax (612) 861-3446
Practice Location
645 WAYZATA BLVD E
WAYZATA MN, 55391-1736, US
Phone (612) 861-1675
Fax (612) 861-3446
Business Location
6425 NICOLLET AVE
RICHFIELD MN, 55423-1668, US
Phone (612) 861-1675
Fax (612) 861-3446
Toxanomy
Taxonomy Code 320600000X
License State Minnesota
License Number 802631
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According to our database, The Storefront Group NPI is 1033293972, taxonomy code is 320600000X and license number is 802631, license state is located at Minnesota. The Storefront Group physically located at 645 Wayzata Blvd E, Wayzata MN, 55391-1736. NPI Number 1033115704 has the healthcare provider type.

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1033293972 NPI number is provided on an as is basis without warranty of any kind. 1033293972 is maintained by the National Plan & Provider Enumeration System. The contents of The Storefront Group are for informational purposes only.