| NPI | 1053905208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDISAAK MOHAMUD Owner 612-306-0639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2021-02-26 |