| NPI | 1568821940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HODAN DUALEH Owner/President 952-594-4467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |