24D2241819 CLIA NUMBER - COMMUNITY OF RECOVERING PEOPLE DBA THE RETREAT

Laboratory Demographics

CLIA Number: 24D2241819

Facility Name: COMMUNITY OF RECOVERING PEOPLE DBA THE RETREAT

Facility Address:
1221 WAYZATA BLVD E
WAYZATA, MN
ZIP 55391
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Facility Phone Number: 952 476-0566

Facility Type: Other - DRUG & ALCOHOL RECOVERY C

Certificate Type: Waiver

NPI Number: 1386277622

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
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.

CLIA Record

Field Name	Field Value
CLIA Number	24D2241819
LAB Type	Other - DRUG & ALCOHOL RECOVERY C
Facility Name	COMMUNITY OF RECOVERING PEOPLE DBA THE RETREAT
Street	1221 WAYZATA BLVD E
City	WAYZATA
State	MN
ZIP	55391
Phone	952 476-0566
CertificateType	4
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024