| Valhalla Place, Llc | |
|
2807 Brookdale Dr Brooklyn Park MN 55444-1844 | |
| (651) 925-8200 | |
| Not Available |
| Full Name | Valhalla Place, Llc |
|---|---|
| Speciality | Clinic/center - Methadone |
| Location | 2807 Brookdale Dr, Brooklyn Park, Minnesota |
| Authorized Official Name and Position | Jay Higham (CEO) |
| Authorized Official Contact | 2143656112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valhalla Place, Llc 6043 Hudson Rd 220 Woodbury MN 55125-1018 Ph: (651) 925-8200 | Valhalla Place, Llc 2807 Brookdale Dr Brooklyn Park MN 55444-1844 Ph: (651) 925-8200 |
| NPI Number | 1801149505 |
|---|---|
| Provider Enumeration Date | 10/18/2012 |
| Last Update Date | 12/23/2024 |
| Certification Date | 12/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801149505 | NPI | - | NPPES |
| 260163778 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 15731 (Minnesota) | Secondary |
| 261QM2800X | Clinic/center - Methadone | 1063405 (Minnesota) | Primary |
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