Organization
PINE MANORS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RACHEL JEAN MUELLER LADC (DIRECTOR CHIEF OPERATING OFFICER)
(218) 732-4337
Entity
Organization
Contact information
Practice address
22195 STATE 34, NEVIS, MN 56467
(218) 732-4337
(218) 732-0399
Mailing address
22195 STATE 34, NEVIS, MN 56467
(218) 732-4337
(218) 732-0399
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
8019182CDT
MN
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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