| Supportive Living Services, Inc. | |
|
5615 Brooklyn Blvd Ste 200 Brooklyn Center MN 55429-3086 | |
| (763) 537-6612 | |
| (763) 537-7162 |
| Full Name | Supportive Living Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5615 Brooklyn Blvd Ste 200, Brooklyn Center, Minnesota |
| Authorized Official Name and Position | Maggie Lynne Loftus (OFFICE MANAGER) |
| Authorized Official Contact | 7632771020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Living Services, Inc. 5615 Brooklyn Blvd Ste 200 Brooklyn Center MN 55429-3086 Ph: (763) 537-6612 | Supportive Living Services, Inc. 5615 Brooklyn Blvd Ste 200 Brooklyn Center MN 55429-3086 Ph: (763) 537-6612 |
| NPI Number | 1417081704 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417081704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Minnesota) | Primary |
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