person
Mr. Del Gene Bacon, LADC
Addiction (Substance Use Disorder) Counselor in Pine City, Minnesota
NPI 1760772586

Del Gene Bacon is an Addiction (Substance Use Disorder) Counselor based in White Bear Lake, MN and is specialized in Addiction (Substance Use Disorder). Del Gene Bacon practices in Pine City, MN and has the professional credentials of LADC. The NPI Number for Del Gene Bacon is 1760772586 and holds a License No. 302602 (Minnesota).

The current practice location address for Del Gene Bacon is 645 3Rd Ave Sw, Pine City, MN and can be reached out via phone at 320-629-1362 and via fax at 320-629-3454.

Location: 645 3Rd Ave Sw, Pine City, MN, 55110-4369
person
Provider Profile Details
NPI Number
1760772586
Provider Name
Del Gene Bacon
Credential
LADC
Provider Entity Type
Individual
Gender
Male
Address
645 3Rd Ave Sw, Pine City, MN, 55110-4369
Phone Number
320-629-1362
Fax Number
320-629-3454
Provider Enumeration Date
04/13/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
645 3Rd Ave Sw
City
State
Zip
55063-1468
Phone Number
320-629-1362
Fax Number
320-629-3454
person
Provider Business Mailing Address Details
Address
645 3Rd Ave Sw
City
State
Zip
55063-1468
Phone Number
320-629-1362
Fax Number
320-629-3454
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
302602 (Minnesota)
Definition
Definition to come...
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