Organization
NEW LIFE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WES VAN ESSEN (ADMINISTRATOR)
(507) 777-4321
Entity
Organization
Contact information
Practice address
130 DAKOTA ST S, WOODSTOCK, MN 56186-1037
(507) 777-4321
(507) 777-4284
Mailing address
130 DAKOTA ST S, WOODSTOCK, MN 56186-1037
(507) 777-4321
(507) 777-4284
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
1033814-1-DS
MN
324500000X
Substance Abuse Rehabilitation Facility
Primary
801702-3-CDT
MN
Other
Enumeration date
07/15/2005
Last updated
08/22/2020
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