| NPI | 1154097368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEG KINDA Billing Manager 651-829-9155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2022-04-26 |