| NPI | 1073987947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL PETERSON Owner 608-332-3490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 01688) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304016) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |