Organization
REM CENTRAL LAKES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
1401 1ST ST NE, SARTELL, MN 56377-2468
(320) 259-6022
Mailing address
6600 FRANCE AVE S, EDINA, MN 55435-1805
(952) 922-6776
(952) 922-6885
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1012250-2-WS
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
532513700
—
MN
Enumeration date
11/21/2006
Last updated
03/04/2023
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