| NPI | 1841764768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB WRICH Executive Director 651-434-0449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |