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General NPI Number Information
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NPI Number | 1316471550
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Entity Type | Organization
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Legal Business Name | STEPS FOR CHANGE
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 6040 EARLE BROWN DR
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2514
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Country | US
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Telephone | 503-550-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 6040 EARLE BROWN DR
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2514
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JANAE OLSON
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Credential | LPCC
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Telephone | 503-550-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | CC00245
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | CC01030
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License Number State | MN
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