| NPI | 1275701666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA MELLADO A & D Program Director 218-335-3567 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-07-18 |