Organization
DIMENSIONS IN RECOVERY II
Active
Parent organization
MAPLE LAKE RECOVERY CENTER, INC.
Other names
Maple Lake Recovery Center, Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAPLE LAKE RECOVERY CENTER, INC.
Authorized official
JUDITH FEENSTRA MS (ADMINISTRATOR)
(612) 501-1197
Entity
Organization
Contact information
Practice address
13637 60TH ST SW, COKATO, MN 55321-4210
(612) 267-2493
Mailing address
PO BOX 308, MAPLE LAKE, MN 55358-0308
(612) 501-1197
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1074026
MN
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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