Provider First Line Business Practice Location Address:
2450 RIVERSIDE AVE S.
Provider Second Line Business Practice Location Address:
F29 ADULT DAY TREATMENT
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-273-9115
Provider Business Practice Location Address Fax Number:
612-273-9110
Provider Enumeration Date:
08/31/2010