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366 Maple Island Rd Burnsville MN 55306-5504 | |
| (651) 260-8707 | |
| (651) 330-4077 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 366 Maple Island Rd, Burnsville, Minnesota |
| Authorized Official Name and Position | Phia Tony Xiong (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6512608707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
366 Maple Island Rd Burnsville MN 55306-5504 Ph: (651) 260-8707 | 366 Maple Island Rd Burnsville MN 55306-5504 Ph: (651) 260-8707 |
| NPI Number | 1285996520 |
|---|---|
| Provider Enumeration Date | 06/12/2012 |
| Last Update Date | 06/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285996520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 17877 (Minnesota) | Primary |
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