| NPI | 1700567682 |
|---|---|
| Doing Business As | MINNESOTA ADULT & TEEN CHALLENGE |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BEAULIEU Contract Representative 612-373-3366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2023-07-25 |