Organization
PCA POSITIVE DIRECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL M WERNER (PRESIDENT)
(763) 684-1610
Entity
Organization
Contact information
Practice address
810 LAWRENCE PKWY, BUFFALO, MN 55313-1045
(763) 684-1610
Mailing address
810 LAWRENCE PKWY, BUFFALO, MN 55313-1045
(763) 684-1610
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A225584700
—
MN
Enumeration date
10/16/2008
Last updated
10/16/2008
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