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General NPI Number Information
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NPI Number | 1295874402
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Entity Type | Organization
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Legal Business Name | CHEMICAL HEALTH CONCEPTS, INC.
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4010 W 65TH ST STE 102
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City | EDINA
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State | MN
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Zip | 55435-1724
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Country | US
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Telephone | 952-920-1351
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Fax |
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Provider Business Mailing Address
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Address Line | 4010 W 65TH ST STE 102
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City | EDINA
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State | MN
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Zip | 55435-1724
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Country | US
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Telephone | 952-920-1351
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ROBERT MUSCALA
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Credential | R.N.
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Telephone | 952-920-1351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 801614-1-CDT
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License Number State | MN
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