| NPI | 1043679350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JO FLEMING Manager, Patient Revenue Cycle 651-213-4286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN R-222037-0) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |