Healthcare Provider Details

I. General information

NPI: 1386811537
Provider Name (Legal Business Name): SUSTAINABLE RESOURCES CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 10TH AVE SE
MINNEAPOLIS MN
55414-1312
US

IV. Provider business mailing address

1081 10TH AVE SE
MINNEAPOLIS MN
55414-1312
US

V. Phone/Fax

Practice location:
  • Phone: 612-870-4255
  • Fax: 612-870-0729
Mailing address:
  • Phone: 612-870-4255
  • Fax: 612-870-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: DAN A NEWMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 612-870-4255