| NPI | 1861165391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAO-HA PHAN Partner 763-265-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2023-10-27 |