| NPI | 1639798101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICH R LATTERNER Khunsi Onikan Treatment Director 651-793-3803 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |