Organization
SHARON SHOFNER ADULT FOSTER CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON CHLORINCE SHOFNER (CARE PROVIDER)
(218) 453-1083
Entity
Organization
Contact information
Practice address
8783 2ND ST SOUTH, BROOKSTON, MN 55711
(218) 453-1083
Mailing address
8783 2ND ST SOUTH, BROOKSTON, MN 55711
(218) 453-1083
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201343-3-AFC
MN
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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