| NPI | 1194321190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIRAHMAN SULEMAN Authorized Official 651-800-5345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2020-12-07 |