| NPI | 1104309434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SCHARR Program Director 612-991-2885 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2018-09-12 |