| Por, Llc | |
|
8441 Wayzata Blvd Ste 103 Golden Valley MN 55426-1349 | |
| (952) 835-6540 | |
| Not Available |
| Full Name | Por, Llc |
|---|---|
| Speciality | Case Management |
| Location | 8441 Wayzata Blvd Ste 103, Golden Valley, Minnesota |
| Authorized Official Name and Position | James W Keenan (CEO) |
| Authorized Official Contact | 6122212441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Por, Llc 14329 Allen Dr Savage MN 55378-2230 Ph: (612) 221-2441 | Por, Llc 8441 Wayzata Blvd Ste 103 Golden Valley MN 55426-1349 Ph: (952) 835-6540 |
| NPI Number | 1336460518 |
|---|---|
| Provider Enumeration Date | 06/22/2010 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336460518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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