| NPI | 1902398860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLEEN HOWELL Associate Director 651-365-3612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MN PENDING) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-12-14 |