Peterson Colonial Homes, Inc.

NPI #1104037985 in Brookston, Minnesota

Provider Information

NPI Number: 1104037985
Entity Type: Organization
Organization Name: Peterson Colonial Homes, Inc.
Primary Specialty: Assisted Living Facility - Assisted Living, Mental Illness
Enumeration Date: May 24, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 4723 NYGAARD ROAD
City: Brookston
State: Minnesota
ZIP Code: 55711-0350
Phone: (218) 878-0642

Authorized Official

Name: DUANE MELVIN SCHRAW
Title: ADMINISTRATOR
Phone: (218) 878-0642

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness	3104A0625X	Primary

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