Healthcare Provider Details

I. General information

NPI: 1235304767
Provider Name (Legal Business Name): OPPORTUNITY PARTNERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11754 191ST AVENUE NORTHWEST
BLOOMINGTON MN
55437-2038
US

IV. Provider business mailing address

5500 OPPORTUNITY CT
MINNETONKA MN
55343-9020
US

V. Phone/Fax

Practice location:
  • Phone: 612-831-4155
  • Fax:
Mailing address:
  • Phone: 952-938-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number804044
License Number StateMN

VIII. Authorized Official

Name: MR. ARMANDO CAMACHO
Title or Position: PRESIDENT & CEO
Credential:
Phone: 952-912-7464