| NPI | 1093927998 |
|---|---|
| Doing Business As | STONERIDGE |
| Entity Type | Organization |
| Authorized Contact | CARMEN MARIE WILSON Owner 320-255-9530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MN 1043554-2-AFC) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |