African American Survivor Services

NPI #1386530178 in Saint Paul, Minnesota

Provider Information

NPI Number: 1386530178
Entity Type: Organization
Organization Name: African American Survivor Services
Primary Specialty: Prevention Professional
Enumeration Date: Jun 17, 2025
Last Updated: Jun 17, 2025

Practice Location

Address: 285 DALE ST N STE 100
City: Saint Paul
State: Minnesota
ZIP Code: 55103-2413
Phone: (612) 306-3416

Authorized Official

Name: IVAN LOUIS NELSON, CPRSR-FE
Title: DIRECTOR/CPRSR
Phone: (612) 306-3416

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prevention Professional	405300000X	Primary

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