| NPI | 1447092515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADUMO AHMED Treatment Director 612-298-3306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |