| NPI | 1396322293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RUNDQUIST Executive Director 612-374-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2021-03-29 |