Provider Demographics
NPI:1699928903
Name:FREEBORN COUNTY ALCOHOLIC REFERRAL CENTER, INC
Entity type:Organization
Organization Name:FREEBORN COUNTY ALCOHOLIC REFERRAL CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ADAMEC
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, NCAC II
Authorized Official - Phone:507-377-5172
Mailing Address - Street 1:916 S BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-4511
Mailing Address - Country:US
Mailing Address - Phone:507-377-5172
Mailing Address - Fax:507-377-5249
Practice Address - Street 1:916 S BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-4511
Practice Address - Country:US
Practice Address - Phone:507-377-5172
Practice Address - Fax:507-377-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health