Organization
VALLEY-LAKE BOY'S HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ALLEN ENGEBRETSON (EXECUTIVE DIRECTOR)
(218) 643-4036
Entity
Organization
Contact information
Practice address
3850 200TH AVE, BRECKENRIDGE, MN 56520-0411
(218) 643-4036
(218) 643-5226
Mailing address
3850 200TH AVE, BRECKENRIDGE, MN 56520-0411
(218) 643-4036
(218) 643-5226
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1036970-1-CRF
MN
Other
Enumeration date
12/24/2007
Last updated
12/24/2007
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