Organization
PARAGON RESIDENTIAL TREATMENT FOR YOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL DRAGER (CHIEF FINANCIAL OFFICER)
(763) 762-6809
Entity
Organization
Contact information
Practice address
12915 63RD AVE N, MAPLE GROVE, MN 55369-6001
(952) 826-8420
Mailing address
12915 63RD AVE N, MAPLE GROVE, MN 55369-6001
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
MN
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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