| NPI | 1346718806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ASPER Director Contracting 612-454-2046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |