| NPI | 1457581233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN NELSON Executive Director 218-894-0034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MN 1054577) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |