| NPI | 1114048170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BARAGA Executive Director 320-202-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 809836-3-CDT) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-07-21 |