Whalio Doctors

NPI 1346455714

Jacy, LLC

Organisation Mental Illness Community Based Residential Treatment Facility Cold Spring, MN

Practice location

Address
614 Emmas Dr SE, Cold Spring, MN 56320-1454
Phone
(320) 685-9847
Mailing address
600 25th Ave S STE 201, Saint Cloud, MN 56301-4866

Authorised official

Name
Carmen Marie Wilson
Title
Owner
Phone
(320) 255-9530

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320800000X Licence 10435532AFC (MN)

Registry record

NPI
1346455714
Entity type
Organization
NPI issued
11 May 2007
Record last updated
22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.