| NPI | 1902392459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY R. VOLKMANN Owner 651-442-8214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 15251) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301542) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |