| Great Lakes Arms Program | |
|
2917 15th Ave S Minneapolis MN 55407-1427 | |
| (612) 414-7739 | |
| Not Available |
| Full Name | Great Lakes Arms Program |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2917 15th Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Abdirahman Dhunkal (BOARD MEMBER) |
| Authorized Official Contact | 6124147739 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Arms Program 2917 15th Ave S Minneapolis MN 55407-1427 Ph: (612) 414-7739 | Great Lakes Arms Program 2917 15th Ave S Minneapolis MN 55407-1427 Ph: (612) 414-7739 |
| NPI Number | 1508477514 |
|---|---|
| Provider Enumeration Date | 08/12/2020 |
| Last Update Date | 08/12/2020 |
| Certification Date | 08/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508477514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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