| NPI | 1104270636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS WAYNE GRIFFIN Psychotherapist 612-859-7108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |