NPI | 1538293915 |
---|---|
Doing Business As | AVALON - COTTAGE GROVE |
Entity Type | Organization |
Authorized Contact | PAUL LINDEMAN Director Revenue Cycle Mgmt 612-326-7566 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 8009954CDT) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2008-09-17 |