| NPI | 1417161423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE BUNDY Controller 612-326-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 830916) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |