Healthcare Provider Details
I. General information
NPI: 1598844177
Provider Name (Legal Business Name): DAKOTA COUNTY RECEIVING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1294 18TH ST E
HASTINGS MN
55033-3680
US
IV. Provider business mailing address
1294 18TH ST E
HASTINGS MN
55033-3680
US
V. Phone/Fax
- Phone: 651-437-4209
- Fax: 651-438-4144
- Phone: 651-437-4209
- Fax: 651-438-4144
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | 1033790-1-DS |
| License Number State | MN |
VIII. Authorized Official
Name:
LOUISE
SKOGSTAD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 651-437-4209