| NPI | 1306588298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LENNOX VP Revenue Operations 612-900-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TC1900X Psychologist, Counseling | |
| 175T00000X Peer Specialist | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 347E00000X Transportation Broker | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2024-06-25 |