| NPI | 1770603011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M OLLENDICK WRIGHT Executive Director 763-277-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X (Licence: MN 331560) |
| 251X00000X | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2013-05-24 |