| NPI | 1023314440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JENKINS BARTEE Executive Director 612-227-2719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: 324500000x) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2011-02-02 |