| NPI | 1306460324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL A WIEDEMANN-WEST Chief Executive Officer 651-774-0011 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2022-08-30 |