| NPI | 1003042656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KAY HANSON Administrator 320-231-9763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1053421) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2012-06-08 |