MRS. RITA MARIE CANNONWOLF B.A T-ADC NPI 1093928459

NPI Information

NPI: 1093928459
Provider Name: MRS. RITA MARIE CANNONWOLF, B.A, T-ADC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Individual
Address:
222 9TH AVE W
ALEXANDRIA, MN
ZIP 56308
Phone: (320) 763-3912
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MRS. Rita Marie Cannonwolf, B.A, T-ADC is a substance abuse rehabilitation facility in Alexandria, MN. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. MRS. Rita Marie Cannonwolf, B.A, T-ADC NPI is 1093928459. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

222 9TH AVE W
ALEXANDRIA, MN
ZIP 56308-221
Phone: (320) 763-3912
Fax: (320) 763-6629

The enumeration date for this NPI number is 5/8/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility			MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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