| NPI | 1306851746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN E MILLS Administrator 218-281-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |