| NPI | 1730207705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL A. WIEDEMANN-WEST CEO 651-774-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MN 800078) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-08-30 |