| NPI | 1407961709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE M HART Ar Manager 952-894-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 802143-1-CDT) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |