MEDICARE: HERITAGE TREATMENT LINK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1306527312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE TREATMENT LINK

Provider Business Mailing Address
First Line	:	1422 W LAKE ST STE 208
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2616
Country	:	US
Telephone Number	:	612-300-3938
Fax Number	:

Provider Business Practice Location Address
First Line	:	1422 W LAKE ST STE 208
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2616
Country	:	US
Telephone Number	:	612-300-3938
Fax Number	:

Authorized Official
Title or Position	:	OWNER/EXECUTIVE DIRECTOR
Name	:	MR. NASIR AFRICA
Credential	:
Telephone Number	:	612-300-3938

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	01/14/2026

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