| NPI | 1851388920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN DAVID SISKA President/ 763-545-3006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |