IndividualActive
Corrie Peltier, LADC
NPI 1114070406 · Substance Abuse Rehabilitation Facility · Stacy, MN
Provider details
- NPI number
- 1114070406
- Entity type
- Individual
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Credential
- LADC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1032392-1-CDT (MN)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
31065 Forest Blvd.
Stacy, MN 55079
Phone: (650) 408-7121
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 30
Stacy, MN 55079-0030
Registry dates
- Enumerated
- 2007-01-19
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.