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Contact Information

CORRIE J PELTIER, LADC
31065 FOREST BLVD.
STACY, MN55079
 Phone: 650-408-7121
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

NPI Profile & details for

NPI # 1114070406
Entity Organization
Organization subpart 1 Not specified
Enumeration date 01/19/2007
Last updated 07/08/2007 - About 19 years ago
Identifiers
MN License # 1032392-1-CDT
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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