| Pear Lake Women's Facility - Outpatient | |
|
2086 Ridgeway Dr Grand Rapids MN 55744-4421 | |
| (218) 327-9944 | |
| (218) 327-9944 |
| Full Name | Pear Lake Women's Facility - Outpatient |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2086 Ridgeway Dr, Grand Rapids, Minnesota |
| Authorized Official Name and Position | Arika Stanley (SUPERVISOR) |
| Authorized Official Contact | 2183279944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pear Lake Women's Facility - Outpatient 2086 Ridgeway Dr Grand Rapids MN 55744-4421 Ph: (218) 327-9944 | Pear Lake Women's Facility - Outpatient 2086 Ridgeway Dr Grand Rapids MN 55744-4421 Ph: (218) 327-9944 |
| NPI Number | 1225357437 |
|---|---|
| Provider Enumeration Date | 05/27/2010 |
| Last Update Date | 03/30/2021 |
| Certification Date | 03/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225357437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10026213CDT (Minnesota) | Primary |
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