Organization
REM WOODVALE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
1836 S CEDAR AVE, OWATONNA, MN 55060-4204
(507) 451-1296
Mailing address
6600 FRANCE AVE S, EDINA, MN 55435-1805
(952) 925-5067
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
830935-4-WS
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295718300
—
MN
Enumeration date
12/19/2006
Last updated
03/05/2023
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