| NPI | 1750636973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HORTENSE JONES Program Administrator 612-250-8799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1061325-1-CDT) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2012-07-14 |
| Last Update Date | 2012-07-14 |