| NPI | 1598165359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB DEVNEY Owner 612-730-7955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MN EA657799) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-08-29 |