Organization
ST. CLOUD HOSPITAL
Active
Other names
Journey Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A. BLAIR (SR. VICE PRESIDENT & CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
1485 10TH AVE NE, SAUK RAPIDS, MN 56379-9838
(320) 259-9149
(320) 259-4565
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7009
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
331506
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178755100
—
MN
Enumeration date
06/09/2008
Last updated
10/08/2019
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