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Organization (NPI-2) Active

Intermediate Care Facility, Intellectual Disabilities

Provider Information

NPI Number
1447390570
Provider Type
Organization / Facility (NPI-2)
Status
Active

Contact & Location

Address
1555 118TH LN NW, COON RAPIDS, MN, 554487579
Phone
(763) 862-5436
Fax
(763) 754-0332

Specialties & Taxonomies

Intermediate Care Facility, Intellectual Disabilities Primary License: MN #1075259

All Addresses

MAILING

1555 118TH LN NW

COON RAPIDS, MN, 554487579

(763) 862-5436

LOCATION

1555 118TH LN NW

COON RAPIDS, MN, 554487579

(763) 862-5436