| 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 |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2024-01-23 |