| NPI | 1184024135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA J GRANBOIS Rece PT Ionist 218-444-6912 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP3903) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |