| New Salem Metamorphosis Adolesent Program | |
|
2507 Bryant Ave N Minneapolis MN 55411-2116 | |
| (612) 250-8799 | |
| Not Available |
| Full Name | New Salem Metamorphosis Adolesent Program |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2507 Bryant Ave N, Minneapolis, Minnesota |
| Authorized Official Name and Position | Hortense Jones (PROGRAM ADMINISTRATOR) |
| Authorized Official Contact | 6122508799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Salem Metamorphosis Adolesent Program 2507 Bryant Ave N Minneapolis MN 55411-2116 Ph: (612) 250-8799 | New Salem Metamorphosis Adolesent Program 2507 Bryant Ave N Minneapolis MN 55411-2116 Ph: (612) 250-8799 |
| NPI Number | 1750636973 |
|---|---|
| Provider Enumeration Date | 07/14/2012 |
| Last Update Date | 07/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750636973 | NPI | - | NPPES |
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