| NPI | 1225335862 |
|---|---|
| Doing Business As | FDL ADULT OUTPATIENT TX |
| Entity Type | Organization |
| Authorized Contact | MARILYN GROVER Associate Director 218-879-1227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MN 012010) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2016-10-10 |