| NPI | 1790506681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY PATRICIA RODENBERG-ROBERTS Chief Regulatory Officer Sr Asst Gc 952-836-2234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 251S00000X Community/Behavioral Health | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2026-07-21 |