Healthcare Provider Details

I. General information

NPI: 1912179433
Provider Name (Legal Business Name): DAKOTA COUNTY RECEIVING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date: 08/01/2008
Reactivation Date: 06/11/2009

III. Provider practice location address

1294 18TH ST E
HASTINGS MN
55033-3680
US

IV. Provider business mailing address

1294 18TH ST E BLDG 2
HASTINGS MN
55033-3680
US

V. Phone/Fax

Practice location:
  • Phone: 651-437-4209
  • Fax: 651-438-4144
Mailing address:
  • Phone: 651-437-4209
  • Fax: 651-438-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberFBL-0020697-25738
License Number StateMN

VIII. Authorized Official

Name: ANGELA COLLINS
Title or Position: ACCOUNTS RECEIVABLE
Credential:
Phone: 651-437-4209