| NPI | 1669842373 |
|---|---|
| Other Name | GLEN CREEK LODGE |
| Entity Type | Organization |
| Authorized Contact | BRIAN P SAMMON President 952-564-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |