NPI | 1518338268 |
---|---|
Entity Type | Organization |
Authorized Contact | PATRICK WILLIAM KEMPER Medical Director 612-644-8835 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1952) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 1952) |
Enumeration Date | 2015-10-07 |
Last Update Date | 2015-10-20 |