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General NPI Number Information
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NPI Number | 1962814871
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Entity Type | Organization
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Legal Business Name | ASSISTANCE IN RECOVERY
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 400 SELBY AVE SUITE D
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City | SAINT PAUL
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State | MN
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Zip | 55102-4508
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Country | US
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Telephone | 651-222-6740
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Fax | 651-222-6743
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Provider Business Mailing Address
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Address Line | 400 SELBY AVE SUITE D
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City | SAINT PAUL
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State | MN
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Zip | 55102-4508
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Country | US
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Telephone | 651-222-6740
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Fax | 651-222-6743
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATIE THIBOUTOT
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Credential |
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Telephone | 651-255-0380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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