| Organization Name: | FOUR WINDS CENTER FOR WELLNESS INC |
| NPI Number: | 1609975713 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALAN LOUIS CIROCCO (COOWNER OPERATOR) |
| Mailing Address: | 28141 Lakelawn Drive Lindstrom |
| State: | MN US |
| Postal Code: | 55045 |
| Phone Number: | 6512579566 |
| Fax Number: | |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 10/03/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |