Healthcare Provider Details

I. General information

NPI: 1225101827
Provider Name (Legal Business Name): NEW VISIONS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 9TH AVE W
ALEXANDRIA MN
56308-2221
US

IV. Provider business mailing address

9547 90TH ST
PRINCETON MN
55371-6910
US

V. Phone/Fax

Practice location:
  • Phone: 320-763-3912
  • Fax:
Mailing address:
  • Phone: 763-389-0499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number301364
License Number StateMN

VIII. Authorized Official

Name: MRS. CHERYL JUDY MINKS
Title or Position: PROGRAM DIRECTOR
Credential: LADC
Phone: 320-763-3912