OrganizationActive
Jacy 2, LLC
NPI 1124212873 · Children's Substance Abuse Rehabilitation Facility · Litchfield, MN
Provider details
- NPI number
- 1124212873
- Entity type
- Organization
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Carmen Wilson, Owner(320) 255-9530
- License
- 1047343 (MN)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
319 Csah #20
Litchfield, MN 55355
Phone: (320) 255-9530
Approximate (ZIP-level) locationGet directions
Mailing address
1096 E 260th St
New Prague, MN 56071-8880
Other names (DBA / former)
- Doing business as
- Wings
Registry dates
- Enumerated
- 2007-09-05
- Last updated
- 2007-09-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.