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1467138529
ICOD LLC
BROOKLYN PARK, MN
NPI
1467138529
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Entity Type
Organization
Authorized Contact
CHUMA DKAE
CEO/Owner
612-205-0571
Organization Subpart ?
No
Primary Taxonomy
261QM0850X Clinic/Center, Adult Mental Health
Enumeration Date
2023-06-23
Last Update Date
2023-06-23
Business Address
ICOD LLC
2616 87TH TRL N
BROOKLYN PARK, MN 55443-3742
Phone number: 612-205-0571
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Mailing Address
ICOD LLC
2616 87TH TRL N
BROOKLYN PARK, MN 55443-3742
Phone number: 612-205-0571
Copy
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