Healthcare Provider Details

I. General information

NPI: 1508154790
Provider Name (Legal Business Name): OPPORTUNITY PARTNERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11754 191ST AVENUE NORTHWEST
WEST ST PAUL MN
55118-3904
US

IV. Provider business mailing address

5500 OPPORTUNITY CT
MINNETONKA MN
55343-9020
US

V. Phone/Fax

Practice location:
  • Phone: 651-457-4756
  • Fax: 651-457-5664
Mailing address:
  • Phone: 952-938-5511
  • Fax: 952-238-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number1060002-1-DTH
License Number StateMN

VIII. Authorized Official

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