| NPI | 1205257060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKRAM EL-AMIN Imam 612-326-5851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2013-12-21 |
| Last Update Date | 2024-02-07 |