| NPI | 1235210568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY A BERRY CEO 320-275-4027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MN FBL001772920487) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |