| NPI | 1801405584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES SMITH Chief Administrative Officer 612-326-7655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-07-28 |