Provider First Line Business Practice Location Address:
1280 NORTH BIRCH LAKE BLVD
Provider Second Line Business Practice Location Address:
WHITE BEAR LAKE AREA COMMUNITY COUNSELING CENTER
Provider Business Practice Location Address City Name:
WHITE BEAR LAKE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55110-6708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-429-8544
Provider Business Practice Location Address Fax Number:
651-407-5301
Provider Enumeration Date:
11/14/2006