NPI | 1760587109 |
---|---|
Entity Type | Organization |
Authorized Contact | JUDITH M FEENSTRA Administrator 612-501-1197 |
Organization Subpart ? | No |
Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MN 810975-1-CRF) |
Enumeration Date | 2006-09-13 |
Last Update Date | 2008-09-03 |