| NPI | 1073474888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S POWELL CEO/Treatment Director 763-290-2736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-11-20 |
| Last Update Date | 2025-11-20 |