| NPI | 1205078771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAISHA I GILES Program Director 612-767-9154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2016-07-26 |