Hope Village, Llc | |
6043 Hudson Rd Suite 372 Woodbury MN 55125-1018 | |
(651) 714-9171 | |
(651) 714-9176 |
Full Name | Hope Village, Llc |
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Speciality | Social Worker - Clinical |
Location | 6043 Hudson Rd, Woodbury, Minnesota |
Authorized Official Name and Position | Rosella Collins-puoch (PRESIDENT) |
Authorized Official Contact | 6126699202 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Hope Village, Llc 6043 Hudson Rd Suite 372 Woodbury MN 55125-1018 Ph: (651) 714-9171 | Hope Village, Llc 6043 Hudson Rd Suite 372 Woodbury MN 55125-1018 Ph: (651) 714-9171 |
NPI Number | 1548539786 |
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Provider Enumeration Date | 12/16/2011 |
Last Update Date | 12/16/2011 |
Identifier | Type | State | Issuer |
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1548539786 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | 18674 (Minnesota) | Primary |
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