Organization
MYSTIC MEADOW HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA L LITKE (ADMINISTRATOR)
(218) 821-3419
Entity
Organization
Contact information
Practice address
40439 348TH LN, AITKIN, MN 56431-5672
(218) 821-3419
Mailing address
16120 COUNTY ROAD 22, BRAINERD, MN 56401-1844
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/02/2007
Last updated
08/02/2007
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