MEADOW CREEK INC NPI 1942413687

NPI Information

  • NPI: 1942413687
  • Provider Name: MEADOW CREEK, INC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • CLIA Number: 24D2056596
  • Address: 17305 MEADOW CREEK LANE
    PINE CITY, MN
    ZIP 55063
  • Phone: (612) 326-7555

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NPI Details

MEADOW CREEK, INC is a substance abuse rehabilitation facility in Pine City, 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. MEADOW CREEK, INC NPI is 1942413687. The provider is registered as an organization entity type.

The provider's business location address is:

17305 MEADOW CREEK LANE
PINE CITY, MN
ZIP 55063
Phone: (612) 326-7555

The provider's authorized official is Valerie Bundy .
The authorized official title is Controller and has the following contact phone number (612) 326-7555.

The CLIA number assigned to this NPI record is 24D2056596 - other - sub treatment facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/8/2007 and was last updated on 8/22/2020.

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
1324500000XSubstance Abuse Rehabilitation Facility1033825MINNESOTAYes

What is NPI?

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This page was last updated on: 11/21/2025

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