Organization
LAKES REGION CHEMICAL DEPENDENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA A DEWEY B.A., LADC (OWNER/TREATMENT DIRECTOR)
(218) 444-5740
Entity
Organization
Contact information
Practice address
1510 BEMIDJI AVE N STE 13, BEMIDJI, MN 56601-3804
(218) 444-5740
(218) 333-0241
Mailing address
1510 BEMIDJI AVE N STE 13, BEMIDJI, MN 56601-3804
(218) 444-5740
(218) 333-0241
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1042531
MN
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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