| NPI | 1740359199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BRADLEY President 612-385-7857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MN 1036380) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2017-03-30 |