| NPI | 1881716025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BARAGA Executive Director 320-202-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 800357-1-CDT) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2010-12-16 |