| NPI | 1497217699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOSTEYA ABDULAHI FARAH President 612-644-3912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2019-04-05 |