Jacy 2, LLC

NPI #1124212873 in Litchfield, Minnesota

Provider Information

NPI Number: 1124212873
Entity Type: Organization
Organization Name: Jacy 2, LLC
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Sep 5, 2007
Last Updated: Sep 5, 2007

Practice Location

Address: 319 CSAH #20
City: Litchfield
State: Minnesota
ZIP Code: 55355
Phone: (320) 255-9530

Authorized Official

Name: CARMEN MARIE WILSON
Title: OWNER
Phone: (320) 255-9530

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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