| NPI | 1699537977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT J KING CEO 651-706-2670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-23 |