Provider Demographics
NPI:1598844177
Name:DAKOTA COUNTY RECEIVING CENTER
Entity Type:Organization
Organization Name:DAKOTA COUNTY RECEIVING CENTER
Other - Org Name:CROW WING COUNTY DETOX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOGSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-437-4209
Mailing Address - Street 1:1294 18TH ST E
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-3680
Mailing Address - Country:US
Mailing Address - Phone:651-437-4209
Mailing Address - Fax:651-438-4144
Practice Address - Street 1:1294 18TH ST E
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-3680
Practice Address - Country:US
Practice Address - Phone:651-437-4209
Practice Address - Fax:651-438-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1033790-1-DS324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility