Organization
ADDICTION COUNSELING TREATMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J. RUESGEN LADC (DIRECTOR)
(507) 237-2716
Entity
Organization
Contact information
Practice address
112 5TH ST., GAYLORD, MN 55334
(507) 238-2716
(507) 237-2736
Mailing address
112 5TH ST., P.O. BOX 700, GAYLORD, MN 55334
(507) 238-2716
(507) 237-2736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10422051CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340090500
—
MN
Enumeration date
10/13/2006
Last updated
06/13/2008
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