| NPI | 1366866907 |
|---|---|
| Doing Business As | DBA ONE TWELVE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL CLIFTON HOLMES Owner 952-513-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1066522) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-02-18 |