| Frazier Recovery Home Llc | |
|
8813 Hale Ave S Cottage Grove MN 55106 | |
| (651) 895-4440 | |
| Not Available |
| Full Name | Frazier Recovery Home Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 8813 Hale Ave S, Cottage Grove, Minnesota |
| Authorized Official Name and Position | Elizabeth Frances Rezek (FOUNDER) |
| Authorized Official Contact | 6518954440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frazier Recovery Home Llc Po Box 142 Cottage Grove MN 55016-0142 Ph: (651) 895-4440 | Frazier Recovery Home Llc 8813 Hale Ave S Cottage Grove MN 55106 Ph: (651) 895-4440 |
| NPI Number | 1801313101 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 08/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801313101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 15804 (Minnesota) | Primary |
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