| NPI | 1043754757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN R. PAREJA Executive Director 320-650-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MN 80388912CRF) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |