| NPI | 1174223473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET GAUTHIER Vice Preside T 651-724-2860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-03-06 |