Provider First Line Business Practice Location Address:
14241 GRAND OAKS DRIVE
Provider Second Line Business Practice Location Address:
BAXTER COMMUNITY BEHAVIORAL HEALTH HOSPITAL
Provider Business Practice Location Address City Name:
BAXTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-316-3101
Provider Business Practice Location Address Fax Number:
218-829-9141
Provider Enumeration Date:
07/20/2007