Organization
PIONEER RECOVERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DAWN NYAKUNDI LADC, CADCIII (ADMINISTRATOR/COUNSELOR)
(218) 638-9931
Entity
Organization
Contact information
Practice address
5388 ROAD 37, AURORA, MN 55705-8338
(218) 638-9931
Mailing address
5388 ROAD 37, AURORA, MN 55705-8338
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
00461
MN
324500000X
Substance Abuse Rehabilitation Facility
301663
MN
324500000X
Substance Abuse Rehabilitation Facility
Primary
301846
MN
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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