| NPI | 1336313485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK JOEL MAZULA CEO 507-288-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1046693-1-CDT) |
| Enumeration Date | 2008-04-19 |
| Last Update Date | 2008-04-19 |