Peterson Family Living

NPI #1205050333 in Elk River, Minnesota

Provider Information

NPI Number: 1205050333
Entity Type: Organization
Organization Name: Peterson Family Living
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 12, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 12400 RIDGEWOOD DR NW
City: Elk River
State: Minnesota
ZIP Code: 55330-8221
Phone: (763) 441-8034

Authorized Official

Name: MRS. KATHIE R PETERSON
Title: RESIDENTIAL COORDINATOR
Phone: (763) 441-8034

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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