Healthcare Provider Details

I. General information

NPI: 1831514876
Provider Name (Legal Business Name): ARBOR THERAPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 02/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 HIGHWAY 100 S STE 300
ST LOUIS PARK MN
55416-1563
US

IV. Provider business mailing address

1660 HIGHWAY 100 S STE 300
ST LOUIS PARK MN
55416-1563
US

V. Phone/Fax

Practice location:
  • Phone: 952-929-0797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL NIEHANS
Title or Position: OWNER
Credential: M.D.
Phone: 952-224-0399