NPI 1003096447
Phoenix Adolescent Outpatient Treatment
Practice location
- Address
- 601 13th Ave SE, Minneapolis, MN 55414-1437
- Phone
- (651) 734-3268
- Fax
- (612) 378-4886
- Mailing address
- 1011 Interlachen Pkwy, Woodbury, MN 55125-8852
Authorised official
- Name
- Howard Louis Meier
- Title
- Director
- Phone
- (651) 230-1895
Registered specialties
Community/Behavioral Health Agency
Primary
Registry record
- NPI
- 1003096447
- Entity type
- Organization
- NPI issued
- 13 Nov 2007
- Record last updated
- 13 Nov 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.