| NPI | 1497569081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH VARBLE Vice President Of Accounting 763-551-8640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-04 |