| NPI | 1518892603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIAS KETEMA Owner 507-351-7505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2026-06-17 |
| Last Update Date | 2026-06-17 |