| NPI | 1194525741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MARVIN BELLAMY Owner 612-261-6769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 405300000X Prevention Professional | |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-03-13 |