| River Ridge, Llc-burnsville Outpatient | |
|
14750 Lac Lavon Dr Burnsville MN 55306-6398 | |
| (952) 894-7722 | |
| Not Available |
| Full Name | River Ridge, Llc-burnsville Outpatient |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 14750 Lac Lavon Dr, Burnsville, Minnesota |
| Authorized Official Name and Position | Brian P Sammon (PRESIDENT) |
| Authorized Official Contact | 9525643000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| River Ridge, Llc-burnsville Outpatient 151 W Burnsville Pkwy Suite 103 Burnsville MN 55337-2524 Ph: (952) 894-7722 | River Ridge, Llc-burnsville Outpatient 14750 Lac Lavon Dr Burnsville MN 55306-6398 Ph: (952) 894-7722 |
| NPI Number | 1164891776 |
|---|---|
| Provider Enumeration Date | 09/24/2015 |
| Last Update Date | 09/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164891776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Minnesota) | Primary |
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