| NPI | 1144387879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RANUM CFO 651-213-4724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: OR nonumber) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |