IndividualActive
Tricia Bastian
NPI 1295291573 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Walker, MN
Provider details
- NPI number
- 1295291573
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1098115 (MN)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 1098115 (MN)
Residential Treatment Facilities
Practice location
607 4th St S
Walker, MN 56484-6400
Phone: (218) 251-1365
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 910
Walker, MN 56484-0910
Registry dates
- Enumerated
- 2019-02-12
- Last updated
- 2019-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.