| NPI | 1154455533 |
|---|---|
| Doing Business As | AVALON - MIDWAY |
| Entity Type | Organization |
| Authorized Contact | PAUL LINDEMAN Director Revenue Cycle Mgmt 612-326-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1004393) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1047590.1.CDT) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-09-15 |