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NPI Code Detail

MEDICARE: COMMUNITY ADDICTION RECOVERY ENTERPRISES

MEDICARE: COMMUNITY ADDICTION RECOVERY ENTERPRISES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center1046305MN

General Provider Information

NPI Number : 1912220229
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY ADDICTION RECOVERY ENTERPRISES
Provider Business Mailing Address
First Line : 444 LAFAYETTE RD N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55155-3802
Country : US
Telephone Number : 651-431-3676
Fax Number : 651-431-7505
Provider Business Practice Location Address
First Line : 3850 200TH AVE
Second Line :
City : BRECKENRIDGE
State : MN
Zip : 56520
Country : US
Telephone Number : 651-431-3676
Fax Number : 651-431-7505
Authorized Official
Title or Position : REGIONAL ADMINISTRATOR
Name : DOUG SEILER
Credential :
Telephone Number : 218-739-7224
Provider Enumeration Date : 03/02/2010
Last Update Date : 03/02/2010

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Directions to “COMMUNITY ADDICTION RECOVERY ENTERPRISES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.