| NPI | 1720680440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATMA ABDILLE CEO 612-361-7727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2024-11-25 |