Organization
LUTHERAN SOCIAL SERVICE OF MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK PETERSON (CEO)
(651) 642-5990
Entity
Organization
Contact information
Practice address
198 PENNY LANE, LEROY, MN 55951
(507) 342-3725
Mailing address
2485 COMO AVE, SAINT PAUL, MN 55108-1445
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
1054398
MN
Other
Enumeration date
07/08/2009
Last updated
07/08/2009
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