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General NPI Number Information
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NPI Number | 1003178500
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Entity Type | Organization
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Legal Business Name | RURAL ENTERPRISE FOR ACCEPTABLE LIVING, INC.
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 109 S 5TH ST STE 700
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City | MARSHALL
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State | MN
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Zip | 56258-1298
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Country | US
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Telephone | 507-532-2221
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Fax | 507-532-2222
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Provider Business Mailing Address
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Address Line | 109 S 5TH ST STE 700
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City | MARSHALL
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State | MN
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Zip | 56258-1298
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Country | US
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Telephone | 507-532-2221
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Fax | 507-532-2222
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | STEVEN K. THOVSON
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Credential |
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Telephone | 507-532-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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