Organization · NPI-2
Ccri, INC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Moorhead, MN
NPI number1295870699
StatusActive
Last updated in NPPESAug 13, 2014
Details
- NPI
- 1295870699
- Entity type
- Organization (NPI-2)
- Legal business name
- Ccri, INC
- Organization subpart
- No
- Enumeration date
- Feb 21, 2007
- Last updated
- Aug 13, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 800502 | MN | Yes |
| 251E00000X | Home Health | – | MN | |
| 251S00000X | Community/Behavioral Health | – | MN | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | MN |
Other names
- Creative Care For Reaching Independence (Doing Business As)
Practice location
2903 15th St SMoorhead, MN 56560-5111
Phone 218-236-6730 · Fax 218-236-1481
Mailing address
2903 15th St SMoorhead, MN 56560-5111
Phone 218-236-6730 · Fax 218-236-1481
Authorized official
Shannon Bock
Executive Director
2182366730
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