On-Belay of Mn Incorporated

NPI #1396706008 in Plymouth, Minnesota

Provider Information

NPI Number: 1396706008
Entity Type: Organization
Organization Name: On-Belay of Mn Incorporated
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Mar 31, 2006
Last Updated: Oct 26, 2011

Practice Location

Address: 115 FORESTVIEW LANE
City: Plymouth
State: Minnesota
ZIP Code: 55441
Phone: (763) 542-9212

Authorized Official

Name: MARCEY THEIS
Title: OFFICE MANAGER
Phone: (763) 367-6981

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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