| NPI | 1144788514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIANA OLUSHOLA GREENE Vice President 612-328-4819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-05 |