| NPI | 1245573435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN MARIE WILSON Chief Manager 507-720-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-05 |