Organization
JUEL FAIRBANKS CHEMICAL DEPENDENCY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE LINDSTROM (EXECUTIVE DIRECOTR)
(651) 644-6204
Entity
Organization
Contact information
Practice address
806 ALBERT ST N, SAINT PAUL, MN 55104-1303
(651) 644-6204
(651) 644-1126
Mailing address
806 ALBERT ST N, SAINT PAUL, MN 55104-1303
(651) 644-6204
(651) 644-1126
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
803854-3-CDT
MN
Other
Enumeration date
03/10/2008
Last updated
03/10/2008
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