Individual provider · Type 1 NPI

Del Gene Bacon, LADC

Addiction (Substance Use Disorder) Counselor · Pine City, MN

NPI number 1760772586 Active

Practice location

645 3rd Ave SW
Pine City, MN 55063-1468

Call (320) 629-1362 Map

Fax (320) 629-3454

Mailing address

2085 Dotte Dr, #103
White Bear Lake, MN 55110-4369

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X302602 (MN)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1760772586

Del Gene Bacon, LADC's National Provider Identifier is 1760772586, issued on Apr 13, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Pine City, MN. The record was last updated on Apr 13, 2011.