| NPI | 1376030700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M BILLINGSLEY Owner/Treatment Director 612-564-8073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2019-09-30 |