| NPI | 1114603438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SAWIE COO Rdinator 612-267-6570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103TH0100X Psychologist Health Service |
| 171M00000X Case Manager/Care Coordinator | |
| 251E00000X Home Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 261QR0800X Clinic/Center Recovery Care | |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-06-22 |