| NPI | 1821550005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA RAE COSCARELLI Director 507-951-9980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-04 |