| NPI | 1104333715 | 
|---|---|
| Former Legal Business Name | REM CENTRAL LAKES, INC. NORTHWAY ACADEMY | 
| Entity Type | Organization | 
| Authorized Contact | MARY PATRICIA RODENBERG-ROBERTS Vice Pres & Sr. Asst Gc 952-836-2234  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities | 
| Additional Taxonomies | 251S00000X Community/Behavioral Health | 
| Enumeration Date | 2018-01-04 | 
| Last Update Date | 2024-01-23 |