| NPI | 1437872660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDMAN AHMEDNUR MOHAMED CEO 952-388-7640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2023-09-30 |