| Avalon Eagan | |
|
1230 Eagan Industrial Rd Ste 100 Eagan MN 55121-1243 | |
| (612) 326-7555 | |
| Not Available |
| Full Name | Avalon Eagan |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1230 Eagan Industrial Rd Ste 100, Eagan, Minnesota |
| Authorized Official Name and Position | Valerie Bundy (CONTROLLER) |
| Authorized Official Contact | 6123267555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avalon Eagan 550 Main St New Brighton MN 55112-3271 Ph: (612) 326-7555 | Avalon Eagan 1230 Eagan Industrial Rd Ste 100 Eagan MN 55121-1243 Ph: (612) 326-7555 |
| NPI Number | 1417161423 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417161423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 830916 (Minnesota) | Primary |
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