| NPI | 1861030991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDMAN A MOHAMED CEO 952-388-7640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2020-12-12 |