| NPI | 1114143989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTIAN J CHIESA Owner 763-427-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 804982-1-CDT) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-06-20 |