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Organization

LIVING WITH DIGNITY CENTER

Active
Other names
Adult Day Service
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALICIA V FAHR PHD (EXECUTIVE DIRECTOR)
(763) 205-3080
Entity
Organization

Contact information

Practice address
11260 QUINN ST NW, COON RAPIDS, MN 55433-3631
(612) 747-0414
(763) 205-3080
Mailing address
11260 QUINN ST NW, COON RAPIDS, MN 55433-3631
(612) 747-0414
(763) 205-3080

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1051192-1-ADC
MN
251S00000X
Community/Behavioral Health Agency
LPC00616
MN

Other

Enumeration date
07/16/2009
Last updated
07/16/2009
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