| NPI | 1023569498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA NORMAN House Manager 218-393-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |