Taxonomy Code 320900000X(320900000x)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility. Providers: 1
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Providers
| NPI | Name | Type | Address |
|---|---|---|---|
|
OWNER Malissa Ann Costanzo |
Individual |
844 8th Ave Se Forest Lake, MN |
How to obtain, renew, or terminate an NPI
Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...
| Taxonomy Code | 320900000X |
| Display Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Taxonomy Group | Residential Treatment Facilities |
| Taxonomy Classification | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Definition | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
| Effective Date | September 30, 2009 |
| Modification Date | September 30, 2009 |