NPI 1093190258
Micah House
Practice location
- Address
- 3047 5th Ave S, Minneapolis, MN 55408-2415
- Phone
- (651) 827-0484
- Fax
- (612) 827-0485
Authorised official
- Name
- Anthony Scott Holmquist-Burks
- Title
- Clinical Supervisor
- Phone
- (612) 827-0484
Registered specialties
Substance Abuse Rehabilitation Facility
Primary
Registry record
- NPI
- 1093190258
- Entity type
- Organization
- NPI issued
- 29 Jul 2015
- Record last updated
- 29 Jul 2015
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.