| NPI | 1629296900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI DIANE WILSON Finance Manager 612-520-9167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 811027-2-CDT) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |