| NPI | 1801149505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA NELSON CFO 612-326-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MN 1063405) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 15731) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2016-11-16 |