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A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Community Based Residential Treatment Facility, Mental Illness |
320800000X | |||
Substance Abuse Disorder Rehabilitation Facility |
324500000X |
| NPI Number | 1629339437 |
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| LBN Legal business name | RE-CREATION RETREAT LLC | ||||
| Authorized official | RANDY SODERQUIST - (OWNER AND CLINICAL DIRECTOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 06/07/2012 | ||||
| Last updated | 11/21/2012 - About 14 years ago | ||||
| Identifiers |
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RE-CREATION RETREAT LLC