| NPI | 1679949044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW RYAN HOROWITZ Owner 612-500-1269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2025-10-14 |