| NPI | 1760118079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MICHELE GOODE Executive Director 651-587-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2023-05-18 |