| Time To Change Llc | |
|
8609 Lyndale Ave S #110 Bloomington MN 55420-2754 | |
| (952) 358-1009 | |
| Not Available |
| Full Name | Time To Change Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8609 Lyndale Ave S, Bloomington, Minnesota |
| Authorized Official Name and Position | Allen Jerome Johnson (CEO) |
| Authorized Official Contact | 9524845401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Time To Change Llc 8609 Lyndale Ave S #110, #214, #215 Bloomington MN 55420-2754 Ph: (952) 358-1009 | Time To Change Llc 8609 Lyndale Ave S #110 Bloomington MN 55420-2754 Ph: (952) 358-1009 |
| NPI Number | 1346633955 |
|---|---|
| Provider Enumeration Date | 03/07/2015 |
| Last Update Date | 03/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346633955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1076645-1-CDT (Minnesota) | Primary |
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