| Havens Of Minnesota Llc | |
|
1003 Cloquet Ave Ste 117 Cloquet MN 55720-1649 | |
| (218) 879-5545 | |
| Not Available |
| Full Name | Havens Of Minnesota Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1003 Cloquet Ave Ste 117, Cloquet, Minnesota |
| Authorized Official Name and Position | Tedd Herman (CEO) |
| Authorized Official Contact | 6128954605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Havens Of Minnesota Llc 2101 Wooddale Dr Ste B Woodbury MN 55125-4442 Ph: (651) 734-9633 | Havens Of Minnesota Llc 1003 Cloquet Ave Ste 117 Cloquet MN 55720-1649 Ph: (218) 879-5545 |
| NPI Number | 1386352862 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 02/13/2025 |
| Certification Date | 02/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386352862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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