| NPI | 1508613795 |
|---|---|
| Former Legal Business Name | PROTEA HEALTH LLC |
| Entity Type | Organization |
| Authorized Contact | FARDOWSA HASSAN IMAN Clinical Director 320-420-4469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2024-05-04 |