| Cook Co Wilderness Outpatient Treatment | |
|
411 W 2nd St Grand Marais MN 55604-2307 | |
| (218) 387-3020 | |
| Not Available |
| Full Name | Cook Co Wilderness Outpatient Treatment |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 411 W 2nd St, Grand Marais, Minnesota |
| Authorized Official Name and Position | Alison Mcintyre (DIRECTOR) |
| Authorized Official Contact | 2183873620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cook Co Wilderness Outpatient Treatment 411 W 2nd St Grand Marais MN 55604-2307 Ph: (218) 387-3020 | Cook Co Wilderness Outpatient Treatment 411 W 2nd St Grand Marais MN 55604-2307 Ph: (218) 387-3020 |
| NPI Number | 1336327410 |
|---|---|
| Provider Enumeration Date | 01/31/2008 |
| Last Update Date | 10/23/2024 |
| Certification Date | 10/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336327410 | NPI | - | NPPES |
| 407791100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 810854-1-CDT (Minnesota) | Primary |
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