Individual provider · Type 1 NPI
Dale Conrad Forslin
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Braham, MN
Practice location
1029 Highway 65 Ste 107
Braham, MN 55006-3360
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 1086211 (MN) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1205340577
Dale Conrad Forslin's National Provider Identifier is 1205340577, issued on Nov 25, 2017. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Braham, MN. The record was last updated on Nov 25, 2017.