NPI | 1073077459 |
---|---|
Entity Type | Organization |
Authorized Contact | SAMATER MAHAMOUD President 952-236-7411 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2019-01-30 |
Last Update Date | 2019-06-12 |