National Provider Identifier Database

JACY 2 LLC
Substance Abuse Treatment, Children

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.


Contact Information

JACY 2, LLC
319 CSAH #20
LITCHFIELD, MN55355
Phone: 320-255-9530
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Treatment, Children 3245S0500X

* Indicates primary specialty

NPI Profile & details for JACY 2, LLC

NPI Number 1124212873
Legal business name
LBN
JACY 2, LLC
Authorized official CARMEN WILSON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/05/2007
Last updated 09/05/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 1047343

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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