NPI | 1124762117 |
---|---|
Entity Type | Organization |
Authorized Contact | PAMELA KING President 651-428-9045 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
Enumeration Date | 2022-04-25 |
Last Update Date | 2024-03-15 |