| NPI | 1619041290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMMERLY CARDINAL Accounts Receivable Supervisor 651-431-3693 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 331062) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-11-09 |