| NPI | 1871627257 |
|---|---|
| Doing Business As | AVALON - PINE CITY ADD AVALON - STUREON LAKE TO THIS NPI NUMBER |
| Entity Type | Organization |
| Authorized Contact | CECILIA A WINSOR Treatment Director 612-916-4876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1054088-1-CDT) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1034226) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1034226-2-CDT) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2009-07-15 |