Valhalla Place, Llc | |
2807 Brookdale Dr Brooklyn Park MN 55444-1844 | |
(651) 925-8200 | |
Not Available |
Full Name | Valhalla Place, Llc |
---|---|
Speciality | Clinic/center - Methadone |
Location | 2807 Brookdale Dr, Brooklyn Park, Minnesota |
Authorized Official Name and Position | Paula Nelson (CFO) |
Authorized Official Contact | 6123267555 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Valhalla Place, Llc 6043 Hudson Rd 220 Woodbury MN 55125-1018 Ph: (651) 925-8200 | Valhalla Place, Llc 2807 Brookdale Dr Brooklyn Park MN 55444-1844 Ph: (651) 925-8200 |
NPI Number | 1801149505 |
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Provider Enumeration Date | 10/18/2012 |
Last Update Date | 11/16/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801149505 | NPI | - | NPPES |
260163778 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 15731 (Minnesota) | Secondary |
261QM2800X | Clinic/center - Methadone | 1063405 (Minnesota) | Primary |
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