Organization
MINNESOTA SPECIALTY HEALTH SYSTEM CAMBRIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ZOOK (CONTROLLER)
(651) 431-3691
Entity
Organization
Contact information
Practice address
1425 E RUM RIVER DR S, CAMBRIDGE, MN 55008-2569
(651) 431-3691
(651) 431-7505
Mailing address
PO BOX 64979, SAINT PAUL, MN 55164-0979
(651) 431-3691
(651) 431-7505
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
804294-9-RS-N
MN
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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