| NPI | 1114468857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY HUNSLEY Executive Director 507-218-4773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 1082019-1-CDT) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |