| NPI | 1558781633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CHRIS MCELVEEN Chief Operation Officer 612-893-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MN 10161012DS) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2021-08-20 |