| NPI | 1669986972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARVIA KIAH HEROLD Chief Financial Officer 612-767-2162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MN 1087569) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2017-11-22 |