| NPI | 1396467395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCIS DE-SOUZA Administrator 952-486-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2022-09-15 |