Organization
FRAZIER RECOVERY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH FRANCES REZEK LICSW (FOUNDER)
(651) 895-4440
Entity
Organization
Contact information
Practice address
8813 HALE AVE S, COTTAGE GROVE, MN 55106
(651) 895-4440
Mailing address
PO BOX 142, COTTAGE GROVE, MN 55016-0142
(651) 895-4440
(651) 528-7030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15804
MN
Other
Enumeration date
08/28/2017
Last updated
08/28/2017
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