| NPI | 1437488533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN JEAN JOHNSON Executive Director 218-947-3543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MN 1055720) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2009-12-18 |