| NPI | 1366334633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMUD ALI Executive Director 651-216-8308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-07-19 |
| Last Update Date | 2025-08-10 |