| NPI | 1720354004 |
|---|---|
| Doing Business As | NEW SALEM METORMORPHOSIS YOUTH PROGRAM |
| Entity Type | Organization |
| Authorized Contact | HORTENESE NENE JONES Program Administrator 612-250-8799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301674) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |