Healthcare Provider Details

I. General information

NPI: 1366361636
Provider Name (Legal Business Name): SOZO RECOVERY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 138TH AVE NW
ANDOVER MN
55304-4080
US

IV. Provider business mailing address

1430 138TH AVE NW
ANDOVER MN
55304-4080
US

V. Phone/Fax

Practice location:
  • Phone: 763-412-4147
  • Fax:
Mailing address:
  • Phone: 763-412-4147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS COFFIELD
Title or Position: OWNER
Credential: LADC
Phone: 763-310-5062