| NPI | 1568684678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBEL GUSTAFSON Northe RN Division Director 218-740-3146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 10075603) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |