| NPI | 1851419345 |
|---|---|
| Doing Business As | DETOX |
| Entity Type | Organization |
| Authorized Contact | MARY J CARPENTER Chief Executive Officer 218-749-2881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2016-04-01 |