Shingobee Island Lodge Incorporated

NPI #1629263827 in Walker, Minnesota

Provider Information

NPI Number: 1629263827
Entity Type: Organization
Organization Name: Shingobee Island Lodge Incorporated
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Sep 11, 2007
Last Updated: Sep 11, 2007

Practice Location

Address: 7185 DEWDROP TRAIL NW
City: Walker
State: Minnesota
ZIP Code: 56484
Phone: (218) 547-7516

Authorized Official

Name: JAMES ROGEN
Title: PRESIDENT
Phone: (218) 547-7516

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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