| NPI | 1093340036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE SLEDGE Co Owner 763-807-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |