Organization
VACKER PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE OLSON (ADMINISTRATOR)
(320) 275-4611
Entity
Organization
Contact information
Practice address
69531 213TH ST, DARWIN, MN 55324-6602
(320) 275-4611
(320) 275-4029
Mailing address
69531 213TH ST, DARWIN, MN 55324-6602
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235210568
NPI
MN
Enumeration date
10/28/2014
Last updated
10/28/2014
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