Abijah'S Hope

Organization Active NPI Community/Behavioral Health Agency · Stillwater, MN

NPI 1053700740 · NPPES record last updated Jan 18, 2015

Key facts

NPI
1053700740
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
21186 (MN)
Legal business name
ABIJAH'S HOPE
Practice address
12058 55TH St N
Stillwater, MN 55082-2029
Phone
(715) 379-1370
NPI assigned
Jan 18, 2015
Organization subpart
No

Authorized official

Name
Anna Marie Pederson, LICSW
Title
Clinical Director
Phone
(320) 219-3192

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 21186 MN Yes

Addresses

Primary practice location

12058 55TH St N
Stillwater, MN 55082-2029

Mailing address

12058 55TH St N
Stillwater, MN 55082-2029
Phone (715) 379-1370

Other providers in Stillwater, MN

All providers in Stillwater, MN · Community/Behavioral Health Agency in Minnesota

Sources for this page

Verify at the official NPI Registry.