| NPI | 1235304767 |
|---|---|
| Doing Business As | LAVINE PLACE |
| Entity Type | Organization |
| Authorized Contact | ARMANDO CAMACHO President & CEO 952-912-7464 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MN 804044) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2014-03-28 |