| NPI | 1487732707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JAMES PAVEK Director 218-639-9521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 800173-1-CDT) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2024-03-04 |