Pioneer Recovery Center LLC

Organization Active NPI Substance Abuse Rehabilitation Facility · Aurora, MN

NPI 1376737064 · NPPES record last updated Sep 5, 2007

Key facts

NPI
1376737064
Entity type
Organization (NPI type 2)
Primary specialty
Substance Abuse Rehabilitation Facility 324500000X
License
301846 (MN)
Legal business name
PIONEER RECOVERY CENTER LLC
Practice address
5388 Road 37
Aurora, MN 55705-8338
Phone
(218) 638-9931
NPI assigned
Sep 5, 2007
Organization subpart
No

Authorized official

Name
Jennifer Dawn Nyakundi, LADC, CADCIII
Title
Administrator/Counselor
Phone
(218) 638-9931

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Pioneer Recovery Center LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 301846 MN Yes
Substance Abuse Rehabilitation Facility 324500000X 301663 MN
Substance Abuse Rehabilitation Facility 324500000X 00461 MN

Addresses

Primary practice location

5388 Road 37
Aurora, MN 55705-8338

Mailing address

5388 Road 37
Aurora, MN 55705-8338

Other providers in Aurora, MN

All providers in Aurora, MN · Substance Abuse Rehabilitation Facility in Minnesota

Sources for this page

Verify at the official NPI Registry.