| NPI | 1063883411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NUR S SAYID President 763-204-8930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2023-03-03 |