Organization
PRAIRIE LAKES YOUTH PROGRAMS BOYS GROUP HOME
Active
Organization
PRAIRIE LAKES YOUTH PROGRAMS BOYS GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE K. MCGILLIVRAY (ACCOUNTS MANAGER)
(320) 235-0975
Entity
Organization
Contact information
Practice address
1013 LAKELAND DR NE, WILLMAR, MN 56201-2114
(320) 235-6895
(320) 231-3818
Mailing address
1804 CIVIC CENTER DR, PO BOX 902, WILLMAR, MN 56201-9446
(320) 235-0975
(320) 214-7067
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
1049804-1-CRF
MN
Other
Enumeration date
01/23/2008
Last updated
01/23/2008
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