| NPI | 1326502865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONI BUFFALOHEAD Managing Director 612-263-8053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2021-05-05 |