Jacy II LLC

NPI #1760929574 in Litchfield, Minnesota

Provider Information

NPI Number: 1760929574
Entity Type: Organization
Organization Name: Jacy II LLC
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Jan 31, 2017
Last Updated: Jan 31, 2017

Practice Location

Address: 1326 E RIPLEY ST
City: Litchfield
State: Minnesota
ZIP Code: 55355-4525
Phone: (320) 593-0440

Authorized Official

Name: MATTIE J MAUMGARATNER
Title: ADMINISTRATOR
Phone: (320) 593-0440

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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