| NPI | 1255623773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERINN JAGIELA Authorized Official 952-447-4344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302795) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |