Ebenezer Adult Day Program
NPI #1174508873 in Minneapolis, Minnesota
Provider Information
- NPI Number
- 1174508873
- Entity Type
- Organization
- Organization Name
- Ebenezer Adult Day Program
- Primary Specialty
- Clinic/Center - Adult Day Care
- Enumeration Date
- Dec 14, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2545 PORTLAND AVE
- City
- Minneapolis
- State
- Minnesota
- ZIP Code
- 55404-4406
- Phone
- (612) 879-2262
Authorized Official
- Name
- MARK THOMAS
- Title
- PRESIDENT/CEO
- Phone
- (612) 874-3460
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Day Care — Adult Day Care |
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