Organization
COUNTY OF COOK
Active
Other names
Cook Co Wilderness Outpatient Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON MCINTYRE (DIRECTOR)
(218) 387-3620
Entity
Organization
Contact information
Practice address
411 W 2ND ST, GRAND MARAIS, MN 55604-2307
(218) 387-3020
Mailing address
411 W 2ND ST, GRAND MARAIS, MN 55604-2307
(218) 387-3020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
810854-1-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407791100
—
MN
Enumeration date
01/31/2008
Last updated
08/08/2025
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