| NPI | 1033403753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY DENNIS CHRISTIANSON Director 218-285-7029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MN 1059889) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |