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General NPI Number Information
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NPI Number | 1124762117
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Entity Type | Organization
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Legal Business Name | CEDAR HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 04/25/2022
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 3300 COUNTY ROAD 10
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3072
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Country | US
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Telephone | 651-428-0945
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 COUNTY ROAD 10
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3072
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Country | US
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Telephone | 651-428-9045
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAMELA KING
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Credential |
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Telephone | 651-428-9045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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