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Contact Information

ACRES FOR LIFE THERAPY & WELLNESS CENTER
12058 55TH ST N
STILLWATER, MN55082-2029
 Phone: 651-257-4159
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for ACRES FOR LIFE THERAPY & WELLNESS CENTER

NPI # 1669825857
LBN Legal business name ACRES FOR LIFE THERAPY & WELLNESS CENTER
Authorized official LYNN MOORE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/22/2016
Last updated 07/22/2016 - About 10 years ago
Identifiers
MN License # 19404
MN Other 8JM77AC BLUECROSS BLUESHIELD OF MINNESOTA
MN Other 1053702910 MINNESOTA HEALTH CARE PROGRAM
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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