| NPI | 1396420469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XAVIER ALEXANDER DAVIS Owner / CEO 612-636-3194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-06-19 |