Organization
MAPLE LKE RECOVERY CENTER INC
Active
Other names
Prairie House Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH M FEENSTRA BS LADC (ADMINISTRATOR)
(612) 501-1197
Entity
Organization
Contact information
Practice address
305 PRAIRIE RD, MONTICELLO, MN 55362-8990
(651) 785-5647
(763) 295-9579
Mailing address
207 DIVISION ST. E., BOX 308, MAPLE LAKE, MN 55358
(320) 963-6865
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
1032184-1-CRF
MN
Other
Enumeration date
09/21/2006
Last updated
07/15/2008
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