| NPI | 1548710916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN GIBBONS Executive Director 320-364-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |