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General NPI Number Information
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NPI Number | 1780850446
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Entity Type | Organization
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Legal Business Name | VOLUNTEERS OF AMERICA OF MINNESOTA
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 5100 HODGSON RD
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City | SAINT PAUL
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State | MN
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Zip | 55126-1229
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Country | US
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Telephone | 651-484-7840
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Fax | 651-484-7971
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Provider Business Mailing Address
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Address Line | 2825 E LAKE ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-1929
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Country | US
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Telephone | 612-721-6327
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Fax | 612-721-1506
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Authorized Official
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Title or Position | DIRECTOR, CORRECTIONAL SERVICES
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Name | WILLIAM NELSON
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Credential |
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Telephone | 612-721-6327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 10100892CDT
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License Number State | MN
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