| NPI | 1568752533 |
|---|---|
| Other Name | MEN'S RESIDENCE |
| Entity Type | Organization |
| Authorized Contact | JEFFREY LARSON Executive Director 763-389-5080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: MN FBL-4868-25062) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN FBL-4868-25062) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2012-07-24 |