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Jacy 1 — NPI 1982879912, Saint Cloud, MN | NPI Central

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NPI 1982879912

OrganizationActive

Jacy 1

NPI 1982879912 · Substance Abuse Rehabilitation Facility · Saint Cloud, MN

Provider details

NPI number: 1982879912
Entity type: Organization
Primary specialty: Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
Organization subpart: No
Authorized official: Laura Litke, Executive Assistant(320) 255-9530
License: 10447991CDT (MN)

Specialties & taxonomies

Substance Abuse Rehabilitation FacilityPrimary324500000XLicense 10447991CDT (MN)
Residential Treatment Facilities

Practice location

600 25th Ave S Ste 105

Saint Cloud, MN 56301-4820

Phone: (320) 255-9530

Approximate (ZIP-level) locationGet directions

More MN providers

Mailing address

600 25th Ave S Ste 105

Saint Cloud, MN 56301-4820

Other names (DBA / former)

Doing business as: Anchorage

Registry dates

Enumerated: 2008-04-30
Last updated: 2008-04-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.