Individual provider · Type 1 NPI
Tricia Bastian
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Walker, MN
Practice location
607 4th St S
Walker, MN 56484-6400
Mailing address
PO Box 910
Walker, MN 56484-0910
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 1098115 (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 1295291573
Tricia Bastian's National Provider Identifier is 1295291573, issued on Feb 12, 2019. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Walker, MN. The record was last updated on Feb 12, 2019.