Redlake Chemical Health Program Group Home

NPI #1225202625 in Redlake, Minnesota

Provider Information

NPI Number: 1225202625
Entity Type: Organization
Organization Name: Redlake Chemical Health Program Group Home
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Apr 16, 2008
Last Updated: Apr 16, 2008

Practice Location

Address: 15797 MAIN AVENUE
City: Redlake
State: Minnesota
ZIP Code: 56671
Phone: (218) 679-3995

Authorized Official

Name: SALENA BRANCHAUD
Title: PROGRAM MANAGER
Phone: (218) 679-3995

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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