| NPI | 1396349965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FERGUSON President/Director 320-281-3727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2022-12-29 |