| NPI | 1629471099 |
|---|---|
| Other Name | COCHRAN OUT PATIENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | RICHARD A TERZICK Executive Director 651-437-4209 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MN 80061110CDT) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2014-10-01 |