| NPI | 1770979601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIANA O GREENE VP/Operations 612-328-4819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1074667) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |