| NPI | 1063136620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY PATRICIA RODENBERG-ROBERTS Vice Pres & Sr. Asst Gc 952-836-2234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2024-03-20 |