MR. EDWIN JADE MAKI LADC BA
NPI 1962598292
Counselor - Addiction (Substance Use Disorder) in Fridley, MN
Active since October 05, 2006
7590 LYRIC LANE NE, UNITY HOSPITAL, FRIDLEY, MN 55432(763) 236-9300(763) 236-4370 Get Directions Write a Review
About Mr. Edwin Jade Maki Ladc Ba NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. EDWIN JADE MAKI LADC BA (NPI 1962598292) is an individual addiction (substance use disorder) provider in Fridley, Minnesota, licensed in Minnesota (301815) and active in the NPI registry since October 2006.
NPPES Registry Identity
NPI1962598292
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. EDWIN JADE MAKICredential: LADC BA
Location Address7590 LYRIC LANE NE, UNITY HOSPITALFridley, MN 55432
Mailing Address5603 Halifax Ave NorthBrookly Lemen, MN 55429 · (763) 536-8787
Phone(763) 236-9300
Fax(763) 236-4370
Sole ProprietorNo
Enumeration DateOctober 5, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1962598292 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in MN · 301815
7590 LYRIC LANE NE, Fridley, MN 55432
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1962598292, enumerated as an "individual" on October 05, 2006.
The provider is located at 7590 LYRIC LANE NE UNITY HOSPITAL FRIDLEY, MN 55432 and the phone number is (763) 236-9300.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
