| NPI | 1679750426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE K. MCGILLIVRAY Accounts Manager 320-235-0975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MN 1049804-1-CRF) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2008-01-23 |