| NPI | 1164737326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG SEILER Regional Administrator 218-736-1882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MN 1056062-1-CDT) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |