| Community Options Fridley Inc. | |
|
5384 5th St Ne Fridley MN 55421-1108 | |
| (763) 572-0009 | |
| (763) 572-1295 |
| Full Name | Community Options Fridley Inc. |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 5384 5th St Ne, Fridley, Minnesota |
| Authorized Official Name and Position | Diane M Ollendick Wright (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7632771038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Options Fridley Inc. 5384 5th St Ne Fridley MN 55421-1108 Ph: (763) 572-0009 | Community Options Fridley Inc. 5384 5th St Ne Fridley MN 55421-1108 Ph: (763) 572-0009 |
| NPI Number | 1154441491 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 05/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154441491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Primary |
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