A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Community Based Residential Treatment Facility, Mental Illness | 320800000X |
| Substance Abuse Disorder Rehabilitation Facility | 324500000X |
* Indicates primary specialty
| NPI Number | 1629339437 |
| Legal business name LBN |
RE-CREATION RETREAT LLC |
| Authorized official | RANDY SODERQUIST - (OWNER AND CLINICAL DIRECTOR) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 06/07/2012 |
| Last updated | 11/21/2012 - About 14 years ago |
| Sole proprietor1 | Not specified |
| Identifiers |
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1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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