| NPI | 1023339389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON MACK CEO 218-525-4126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-06-21 |