Healthcare Provider Details

I. General information

NPI: 1659218733
Provider Name (Legal Business Name): KAIZENRIDGE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 110TH AVE NW
COON RAPIDS MN
55448-4435
US

IV. Provider business mailing address

725 LILIUM TRL
MEDINA MN
55340-4442
US

V. Phone/Fax

Practice location:
  • Phone: 612-524-8103
  • Fax:
Mailing address:
  • Phone: 612-524-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: ADELEYE OYEDEPO
Title or Position: CO-FOUNDER
Credential:
Phone: 612-524-8103