| NPI | 1609468586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASSAN ABDULLAHI MOHAMUD Owner 651-417-3754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2021-02-11 |
| Last Update Date | 2021-02-11 |