NPI | 1629117452 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMY JON JOHNSON Program Cooridanator 651-633-4532 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 820357100) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2008-04-28 |