| NPI | 1588110530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLARD L. JOHNSON Director Of Operations 218-283-3406 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 301742) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |