| Ridgewell Living Llc | |
|
2353 Rice St Ste 203 Roseville MN 55113-3775 | |
| (763) 237-5665 | |
| (763) 647-1477 |
| Full Name | Ridgewell Living Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2353 Rice St Ste 203, Roseville, Minnesota |
| Authorized Official Name and Position | Valentine Tazoh (PRESIDENT) |
| Authorized Official Contact | 7635019878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgewell Living Llc 2353 Rice St Ste 203 Roseville MN 55113-3775 Ph: (763) 237-5665 | Ridgewell Living Llc 2353 Rice St Ste 203 Roseville MN 55113-3775 Ph: (763) 237-5665 |
| NPI Number | 1144918277 |
|---|---|
| Provider Enumeration Date | 04/26/2023 |
| Last Update Date | 04/27/2023 |
| Certification Date | 04/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144918277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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