ALLIANCE WELLNESS CLINIC INC. NPI 1780186130

NPI Information

ALLIANCE WELLNESS CLINIC INC. is a methadone clinic center in Bloomington, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. ALLIANCE WELLNESS CLINIC INC. NPI is 1780186130. The provider is registered as an organization entity type.

The provider's business location address is:

8040 OLD CEDAR AVE. S. STE. 100
BLOOMINGTON, MN
ZIP 55425-211
Phone: (952) 693-0080
Fax: (952) 955-6567

The provider's authorized official is Patricia Joann Friedman .
The authorized official title is Treatment Director and has the following contact phone number (952) 693-0080.

The CLIA number assigned to this NPI record is 24D2152568 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/1/2018 and was last updated on 4/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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