| New Salem Metormorphosis Youth Program | |
|
2509 Bryant Ave North Minneapolis MN 55411 | |
| (612) 250-8799 | |
| (612) 529-9416 |
| Full Name | New Salem Metormorphosis Youth Program |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2509 Bryant Ave North, Minneapolis, Minnesota |
| Authorized Official Name and Position | Hortenese Nene 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 Metormorphosis Youth Program 2507 Bryant Ave N Minneapolis MN 55411-2116 Ph: (612) 250-8799 | New Salem Metormorphosis Youth Program 2509 Bryant Ave North Minneapolis MN 55411 Ph: (612) 250-8799 |
| NPI Number | 1720354004 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 03/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720354004 | NPI | - | NPPES |
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