| NPI | 1538874268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEJA M ALLEN President 612-990-8862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-01-17 |