OrganizationActive
Abijah'S on the Backside
NPI 1245099837 · Community/Behavioral Health Agency · Shakopee, MN
Provider details
- NPI number
- 1245099837
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Sally Mixon, Founder / Ceo(715) 379-1370
Specialties & taxonomies
Agencies
Practice location
1100 Canterbury Rd S
Shakopee, MN 55379-1867
Phone: (715) 379-1370
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 583
Shakopee, MN 55379-0583
Registry dates
- Enumerated
- 2024-03-15
- Last updated
- 2024-03-15
- Certified
- 2024-03-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.