| NPI | 1346933645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH VARBLE Corporate Controller 763-551-8640 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| 273R00000X Psychiatric Unit | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2023-06-01 |