| NPI | 1194014134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMMERLY CARDINAL Accounts Receivable Supervisor 651-431-3693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MN 1058767-1-RMI) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2023-11-09 |