| NPI | 1447139779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIDYA BEYENE Administrator 651-403-0259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-08-29 |
| Last Update Date | 2025-08-29 |