Provider Demographics
NPI:1336264076
Name:FAITH FAMILY RECOVERY CENTER LLC
Entity Type:Organization
Organization Name:FAITH FAMILY RECOVERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREATMENT DIRECTOR OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:LADC BCC
Authorized Official - Phone:651-437-1628
Mailing Address - Street 1:1303 S FRONTAGE RD STE 11
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-2478
Mailing Address - Country:US
Mailing Address - Phone:651-437-1628
Mailing Address - Fax:651-437-4165
Practice Address - Street 1:1303 S FRONTAGE RD STE 11
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2478
Practice Address - Country:US
Practice Address - Phone:651-437-1628
Practice Address - Fax:651-437-4165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder