| NPI | 1023479706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARTUN AHMED Owner 612-735-3991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1080128) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2018-07-18 |