Healthcare Provider Details

I. General information

NPI: 1679365027
Provider Name (Legal Business Name): STRONGER SOBER HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 FARRINGTON ST
SAINT PAUL MN
55103-2011
US

IV. Provider business mailing address

1790 SPINAKER DR
SAINT PAUL MN
55125-8632
US

V. Phone/Fax

Practice location:
  • Phone: 651-387-9814
  • Fax:
Mailing address:
  • Phone: 651-387-9814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: CHAD UNGER
Title or Position: PRESIDENT
Credential:
Phone: 651-387-9814