| NPI | 1124616891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA PACHECO Owner 651-347-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-07 |