Provider Demographics
NPI:1073252581
Name:ASCERTAIN RECOVERY CENTRE' LLC
Entity Type:Organization
Organization Name:ASCERTAIN RECOVERY CENTRE' LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLETTE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-245-9966
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:SANDSTONE
Mailing Address - State:MN
Mailing Address - Zip Code:55072-0286
Mailing Address - Country:US
Mailing Address - Phone:320-245-9966
Mailing Address - Fax:
Practice Address - Street 1:413 COMMERCIAL AVE N
Practice Address - Street 2:
Practice Address - City:SANDSTONE
Practice Address - State:MN
Practice Address - Zip Code:55072-4412
Practice Address - Country:US
Practice Address - Phone:320-245-9966
Practice Address - Fax:320-310-0433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCERTAIN RECOVERY CENTRE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health