Organization
PREFERRED RESIDENTIAL LIFESTYLES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
220 MILWAUKEE ST STE 2, LAKEFIELD, MN 56150-9495
(952) 563-2207
(952) 922-6885
Mailing address
6600 FRANCE AVE S, EDINA, MN 55435-1805
(952) 922-6776
(952) 922-6885
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1071036-1-HCBS
—
MN
Enumeration date
10/18/2017
Last updated
03/04/2023
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