| River Ridge Llc Four Seasons Outpatient | |
|
4205 Lancaster Ln N Ste 101 Plymouth MN 55441-1702 | |
| (952) 894-7722 | |
| (952) 894-0882 |
| Full Name | River Ridge Llc Four Seasons Outpatient |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 4205 Lancaster Ln N Ste 101, Plymouth, Minnesota |
| Authorized Official Name and Position | Patricia Patche (CFO) |
| Authorized Official Contact | 9525643000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| River Ridge Llc Four Seasons Outpatient 615 W Travelers Trl Burnsville MN 55337-2553 Ph: (952) 894-7722 | River Ridge Llc Four Seasons Outpatient 4205 Lancaster Ln N Ste 101 Plymouth MN 55441-1702 Ph: (952) 894-7722 |
| NPI Number | 1295105906 |
|---|---|
| Provider Enumeration Date | 10/07/2015 |
| Last Update Date | 07/19/2022 |
| Certification Date | 07/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295105906 | NPI | - | NPPES |
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