| Organization Name: | RUM RIVER HEALTH SERVICES, INC. |
| NPI Number: | 1528345493 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY LARSON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 640 3rd Street Ne Milaca |
| State: | MN US |
| Postal Code: | 56353 |
| Phone Number: | 7633895080 |
| Fax Number: | 7636319117 |
| NPI Enumeration Date: | 11/07/2011 |
| NPI Last Update Date: | 11/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1060530-1-CDT |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |