Organization
DRAKE RESIDENTIAL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERI VAREBERG (BUSINESS MANAGER)
(701) 293-5429
Entity
Organization
Contact information
Practice address
28579 US HIGHWAY 10, DETROIT LAKES, MN 56501-7308
(218) 844-5191
(218) 844-5193
Mailing address
1202 23RD ST S, FARGO, ND 58103-2951
(701) 293-5429
(701) 293-0736
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
1050972
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3002
—
ND
Enumeration date
09/10/2008
Last updated
09/10/2008
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