| NPI | 1679781116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE GOGGLEYE Chairman 218-335-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |