| NPI | 1245397959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RANUM CFO 651-213-7424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-9403-0001-P) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |