| NPI | 1306629845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA R KATCHMARK Owner 612-559-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |