Organization
COCHRAN RECOVERY SERVICES, INC.
Active
Parent organization
COCHRAN RECOVERY SERVICES, INC.
Other names
Cochran Out Patient Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
COCHRAN RECOVERY SERVICES, INC.
Authorized official
MR. RICHARD A TERZICK MA (EXECUTIVE DIRECTOR)
(651) 437-4209
Entity
Organization
Contact information
Practice address
310 VERMILLION ST, HASTINGS, MN 55033-1237
(651) 438-2639
(651) 438-2752
Mailing address
1294 18TH ST E, HASTINGS, MN 55033-3680
(651) 437-4209
(651) 438-4144
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
80061110CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134394828
—
MN
05
—
1629471099
—
MN
05
—
1821491465
—
MN
Enumeration date
09/30/2014
Last updated
10/01/2014
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