Organization
SHINGOBEE ISLAND LODGE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ROGEN (PRESIDENT)
(218) 547-7516
Entity
Organization
Contact information
Practice address
7185 DEWDROP TRAIL NW, WALKER, MN 56484
(218) 547-7516
Mailing address
PO BOX 530, 7185 DEWDROP TRAIL NW, WALKER, MN 56484-0530
(218) 547-7516
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1005081-1-AFC
MN
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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