| NPI | 1649377706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARRIS L. GLOVER Executive Director 651-659-0359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1038424-1-CDT) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |