| NPI | 1801514625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE ANN PHILLIPS Treatment Director 612-759-5742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-08-17 |
| Last Update Date | 2022-08-17 |