NPI | 1215569678 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON REED Owner 763-577-2489 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2020-02-04 |
Last Update Date | 2021-10-02 |