| NPI | 1508437997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA AGHENTA Administrator 651-955-6535 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-07-07 |