| NPI | 1376076604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS EDWARD ECHOLES Renaissance Counselor 612-767-9187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 3245000000X) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |