| NPI | 1467168757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALEB REID CEO 651-800-5991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2024-01-26 |