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General NPI Number Information
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NPI Number | 1699418210
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH INTEGRATION
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 1471 HIGHVIEW AVE
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City | EAGAN
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State | MN
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Zip | 55121-1143
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Country | US
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Telephone | 651-233-8379
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Fax |
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Provider Business Mailing Address
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Address Line | 1471 HIGHVIEW AVE
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City | EAGAN
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State | MN
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Zip | 55121-1143
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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 | OWNER/LADC
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Name | JACOB THOMAS MINNIG
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Credential | MA, LADC
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Telephone | 651-233-8379
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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 |
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License Number State |
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