| NPI | 1619233459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS BREILAND Director 218-728-9195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MN 800121) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2012-04-05 |